ABSTRACT
OBJECTIVES: To explore the status of reproductive health and related factors in female patients with systemic sclerosis (SSc). METHODS: A cross-sectional study was conducted among female patients from the Chinese Organization for Scleroderma through a questionnaire. Data on the status of reproductive health including fertility condition and menstrual status were obtained. The clinical and laboratory data of SSc were collected. For patients with pregnancies after disease onset, each pregnancy was matched with a healthy control. Associations between clinical characteristics and the status of reproductive health were analyzed. RESULTS: A total of 342 female patients with SSc were included, and 31.8% (108/342, 95% CI 26.9%-36.7%) of them presented problems with reproductive health. Compared with the national data, the menopausal age of patients with disease onset before menopause was earlier (45.2 ± 6.1 vs 48.2 ± 4.4, Pï¼ 0.001). Age of disease onset (p = 0.018) and digital ulcer (p = 0.020) had statistically significant effects on menopausal age. Although the infertility rate of patients was not increased, the rate of spontaneous abortions was higher compared with the national data (9/74, 12.2% vs 4.3%, Pï¼ 0.001). Compared with the healthy control group, the rate of premature infants (12/55, 21.8% vs 7/110, 6.4%, p = 0.003), low birth weight infants (15/55, 27.3% vs 6/110, 5.5%, Pï¼ 0.001), and cesarean section (27/55, 49.1% vs 21/110, 19.1%, Pï¼ 0.001) increased significantly. CONCLUSION: The impairment of reproductive health is common and in many quarters in patients with SSc. Further action should be taken to improve reproductive health in patients with SSc, especially in maternal care.
ABSTRACT
BACKGROUND: Conventional total fertilization failure (TFF) is a challenging problem for clinicians. The predictive model developed in this study aims to predict the individual probability of conventional in vitro total fertilization failure. METHODS: The prediction model was developed based on 1635 patients who underwent first-attempt in vitro fertilization (IVF) cycles from January 2018 to January 2020. Total fertilization failure and normal fertilization occurred in 218 and 1417 cycles, respectively. Multivariate logistic regression analyses were used to develop the prediction model. Performance of our model was evaluated using calibration (Hosmer-Lemeshow test) and discrimination (area under the receiver operating characteristic curve [AUC]). RESULTS: Thirteen risk factors for TFF were included in the prediction model, as follows: female age; female body mass index; infertility duration; number of oocytes retrieved; stimulation protocol; infertility etiology; infertility diagnosis; male age; sperm concentration; total sperm motility; normal sperm morphology percentage; swim-up sperm motility; and swim-up sperm concentration. The AUC of our model was 0.815 (95% CI: 0.783-0.846), indicating satisfactory discrimination performance. CONCLUSION: Considering female and male factors (especially sperm parameters), we established a model that predicts the probability of TFF in conventional IVF procedures that will be helpful in the laboratory supporting IVF to facilitate physicians in determining optimal treatment.
