Dados do Trabalho

Title

CORRELATION BETWEEN THE NUMBER OF PREGNANCIES AND ABORTIONS AND THE CAUSE OF INFERTILITY IN PATIENTS AT A PUBLIC CENTER FOR ASSISTED HUMAN REPRODUCTION (RHA) IN BRAZIL

Objective

To analyze the correlation between the number of pregnancies and abortions and the infertility factor of couples who underwent assisted human reproduction (AHR) procedures in a public center in Brazil.

Methods

The cause of infertility and the female age group of 155 couples who had pregnancy by Human Artificial Insemination (HAI) and Intracytoplasmic Sperm Injection (ICSI) between December 2013 and March 2023 and the incidence of missbirth in 123 couples were analyzed. who obtained pregnancy between the years 2013 to 2018 by RHA procedures, according to the cause of infertility and female age group.

Results

The highest number of ICSI pregnancies occurred among couples whose cause of infertility was male factor (75), followed by tubal factor (53), ovarian factor (22), endometriosis (14), smaller numbers were found for infertility without apparent cause (ISCA) (5), female age factor (3) and female hypogonadotropic hypogonadism (1). Greater numbers of pregnancies by HAI occurred in couples with ISCA (14), followed by ovarian factor (4), male factor (3) and endometriosis (1). There was no occurrence of abortions in patients who underwent HAI. The number of abortions in couples who underwent ICSI was higher for those with infertility factor male (11) and tubal (11), followed by ovarian factor (4) and female age factor. The female age group with the highest incidence of pregnancy was 31 to 37 years (52%), followed by ≥ 38 years (30%) and ≤ 30 years (18%). And the incidence of abortion accompanied the number of pregnancies, being higher in the female age group from 31 to 37 years (55%), followed by the group ≥ 38 years (32%) and ≤ 30 years (14%).

Conclusion

A greater number of pregnancies by ICSI were identified in couples whose cause of infertility was a male factor. Thus, the analysis proves what is already evidenced in the literature, that ICSI has allowed couples in which the partner has some seminal alteration to develop a pregnancy that would not be possible naturally. The second highest number of pregnancies was identified in couples with tubal factor as the cause of infertility, this result was expected because, in vitro fertilization allows external fertilization, this overcomes the limitations of tubal alterations. Pregnancies by HAI occurred in greater numbers in couples with an undetermined cause of infertility. An important result to be emphasize is absent of abortion among couples who underwent HAI between the years 2013 to 2018.In the same period, the highest abortion rate was correlated with the male infertility factor, once to the low genetic quality of spermatozoa can induce miscarriage. The female age group with the highest incidence of pregnancies and also abortions was between 31 and 37 years, significantly higher proportion than for the group of 38 years or older. For patients aged 30 years or less, the number of pregnancies was lower, mainly due to the low demand for AHR treatments in this age group. This work presented an overview of the number of pregnancies and abortions related to the infertility factor and female age group within a group of patients who underwent AHR treatment at a Center of the public helth system.

Keywords

Assisted Human Reproduction, pregnancy, abortion, infertility.

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