| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 1.06 MB | Adobe PDF |
Authors
Abstract(s)
Introdução: A infertilidade é considerada pela Organização Mundial de Saúde como uma doença com fortes implicações individuais, demográficas e económicas, e ainda como problema de saúde pública, afetando milhões de pessoas globalmente. O advento da Reprodução Medicamente Assistida foi um dos grandes progressos nesta área da Medicina, sendo de enorme relevância unir esforços no sentido de estudar e otimizar as técnicas utilizadas, como é o caso da inseminação intrauterina.
Objetivos: Conhecer a taxa de sucesso dos ciclos de inseminação intrauterina realizados na Unidade de Medicina Reprodutiva do Centro Hospitalar Cova Da Beira, EPE, assim como analisar os fatores preditivos de sucesso. Para além disso, pretende-se caracterizar as variáveis sociodemográficos e clínicas dos casais que recorreram a inseminação intrauterina.
Método: Este estudo é um estudo observacional, analítico e retrospetivo. A população em estudo corresponde à dos ciclos de inseminação intrauterina realizados na Unidade de Medicina Reprodutiva do Centro Hospitalar Cova de Beira, compreendidos entre o período de janeiro de 2013 e dezembro de 2016, cuja total é de 126 ciclos, dos quais resultaram 113 ciclos de inseminação para análise.
Resultados: Verificou-se que, dos 113 ciclos em estudo, o grupo etário mais frequente em ambos os elementos do casal foi o dos 30-34 anos (60,2% nas mulheres e 49,6% nos homens). Grande percentagem das mulheres (68,8%) tinha índice de massa corporal (IMC) inferior a 25, não tinha antecedentes relevantes (35,7%), não revelou alterações na avaliação ecográfica anterior à inseminação (79,5%) e tinha espessura do endométrio igual ou superior a 8 mm (73,2%). Na maior parte dos casos (66,4%), nenhum dos elementos do casal é fumador.
A infertilidade foi primária em 71,7% dos casos, em 79,1% tinha duração igual ou inferior a 60 meses (com média de cerca 46 meses) e em 56,6% tinha causa feminina.
Dos ciclos realizados, 20,4% (n=23) resultou num teste Beta HCG positivo. No entanto, a taxa de gravidez clínica (confirmada por avaliação ecográfica) foi de 15,9% (n=18), uma vez que houve gravidezes bioquímicas (n=4) e um aborto tubário. Em 33,3% (n=6) dessas gravidezes viáveis (n=18) houve aborto (ocorrendo a maior parte no 1º trimestre (83,3%)). Assim, a taxa de gravidez a termo, ou seja, de fetos nascidos, foi de 10,6% (n=12).
Discussão: Neste estudo, a taxa de gravidez decorrente da inseminação intrauterina foi de 20,4%. Na bibliografia são encontradas taxas de gravidez bastante abrangentes, uma vez que as características de cada estudo e da amostra em causa influenciam fortemente os resultados. Neste sentido, averiguaram-se os possíveis fatores preditivos de gravidez e concluiu-se que mulheres mais jovens estão associadas a taxas de sucesso superiores. Quanto às restantes variáveis estudadas, não foi possível encontrar associação significativa com a taxa de gravidez.
Introduction: Infertility is a disease that affects millions of people worldwide. World Health Organization refers to it as public health problem with strong individual, demographic and economic implications. The advent of medically assisted reproduction was one of the great breakthroughs in the field, and it is crucial to join efforts and resources towards the study and optimization of the techniques, such as the intrauterine insemination procedure. Goals: Get to know the success rate of the intrauterine insemination cycles performed at the Reproductive Medicine Unit of Centro Hospitalar Cova Da Beira EPE as well as to analyze the predictive factors of success. Furthermore, it is intended to describe the sociodemographic and clinic variables of couples who have resorted to intrauterine insemination. Method: This is an observational, analytical and retrospective study. The target population refers to intrauterine insemination cycles performed at the Reproductive Medicine Unit of Centro Hospitalar Cova Da Beira EPE between January 2013 and December 2016, whose total sample size is 126 cycles, resulting in 113 cycles of insemination for further analyze. Results: It was observed that out of the 113 cycles under study, the most frequent age group in both partners was 30-34 years old (60,2% in women, 49,6% in man). A great fraction of women had a body mass index (BMI) less than 25 (68,8%), had no relevant clinic history (35,7%), didn’t display changes in the pre-insemination ultrasound evaluation (79.5%) and had an endometrial thickness equal or greater than 8 mm (73,2%). In most cases, none of the partners is a smoker (66,4%). Primary infertility was identified in 71,7% of the cases, of which 79,1% lasted 60 months or less (average around 46 months), and in 56,6% of the cycles a female caused was detected. An overall success rate of 20,4% was achieved, defined by a positive Beta HCG test, that is pregnancy. However, the clinical pregnancy rate (confirmed by echographic evaluation) was 15,9% (n=18), since there were biochemical pregnancies (n=4) and a tubal abortion. 33,3% (n=6) of viable pregnancies (n=18) ended as abortion, mostly occurring in the first trimester (83,3%). The delivery rate was 10,6% (n=12). Discussion: In this study, the pregnancy rate obtained from intrauterine insemination was 20,4%. In the literature, pregnancy rates found are quite broad, since the features of each study and sample strongly influence the results. Therefore, the predictive factors of pregnancy were evaluated and it was concluded that a higher success rate is associated with younger women. No statistical evidence was detected among the other studied variables.
Introduction: Infertility is a disease that affects millions of people worldwide. World Health Organization refers to it as public health problem with strong individual, demographic and economic implications. The advent of medically assisted reproduction was one of the great breakthroughs in the field, and it is crucial to join efforts and resources towards the study and optimization of the techniques, such as the intrauterine insemination procedure. Goals: Get to know the success rate of the intrauterine insemination cycles performed at the Reproductive Medicine Unit of Centro Hospitalar Cova Da Beira EPE as well as to analyze the predictive factors of success. Furthermore, it is intended to describe the sociodemographic and clinic variables of couples who have resorted to intrauterine insemination. Method: This is an observational, analytical and retrospective study. The target population refers to intrauterine insemination cycles performed at the Reproductive Medicine Unit of Centro Hospitalar Cova Da Beira EPE between January 2013 and December 2016, whose total sample size is 126 cycles, resulting in 113 cycles of insemination for further analyze. Results: It was observed that out of the 113 cycles under study, the most frequent age group in both partners was 30-34 years old (60,2% in women, 49,6% in man). A great fraction of women had a body mass index (BMI) less than 25 (68,8%), had no relevant clinic history (35,7%), didn’t display changes in the pre-insemination ultrasound evaluation (79.5%) and had an endometrial thickness equal or greater than 8 mm (73,2%). In most cases, none of the partners is a smoker (66,4%). Primary infertility was identified in 71,7% of the cases, of which 79,1% lasted 60 months or less (average around 46 months), and in 56,6% of the cycles a female caused was detected. An overall success rate of 20,4% was achieved, defined by a positive Beta HCG test, that is pregnancy. However, the clinical pregnancy rate (confirmed by echographic evaluation) was 15,9% (n=18), since there were biochemical pregnancies (n=4) and a tubal abortion. 33,3% (n=6) of viable pregnancies (n=18) ended as abortion, mostly occurring in the first trimester (83,3%). The delivery rate was 10,6% (n=12). Discussion: In this study, the pregnancy rate obtained from intrauterine insemination was 20,4%. In the literature, pregnancy rates found are quite broad, since the features of each study and sample strongly influence the results. Therefore, the predictive factors of pregnancy were evaluated and it was concluded that a higher success rate is associated with younger women. No statistical evidence was detected among the other studied variables.
Description
Keywords
Fatores Preditivos Infertilidade Inseminação Intrauterina Reprodução Medicamente Assistida