目的：通过分析涟水地区不孕不育症的主要病因分布及影响因素，探讨如何在基层卫生和计划生育服务机构开展不孕不育初诊和治疗工作。方法：对2014年1月-2015年6月在涟水县计划生育指导站不孕不育门诊就诊的300例不孕不育夫妇进行不孕不育的病因调查。结果：300例夫妇中原发不孕184例（61.3%），继发不孕116例（38.7%）。不孕原因中女方因素201例（67.0%），男方因素59例（19.7%），男女双方因素30例（10.0%），原因不明10例（3.3%）。女性不孕原因以输卵管因素为主，其次是排卵因素；而男性不育以少精、弱精症居首，其次为死精、无精症。结论：应加强女性妇科相关疾病的防治和男性生精功能障碍的机制研究。应尽快在基层建立不孕不育症专科门诊，为不孕不育症患者提供技术服务，向不孕不育症夫妇普及生理卫生科学知识，做到早发现、早治疗。%Objective:To analyze the distribution of primary cause and impact factors of infertility in Lianshui district,in order to explore how the diagnosis and treatment of infertility cases are carried out among the primary-level health and family planning agencies.Method:From January 2014 to June 2015,300 infertile couples who admitted to family planning clinics of Lianshui district were investigated by standardized questionnaire. Result:In 300 couples,184 couples(61.3%) were primary infertility and 116 couples (38.7%) were secondary infertility.There were 201 couples(67.0%) of female infertility,59 couples(19.7%) of male infertility,30 couples(10.0%) of combined infertility and 10 couples(3.3%) of unexplained infertility.Primary causes of female infertility were fallopian tube problems,then ovulatory problems.The causes of male infertility with oligospermia and asthenospermia first,followed by dead sperm and azoospermia.Conclusion:Strengthening the prevention and treatment of gynecological disease and the mechanism study on male spermatogenesis dysfunction is necessary. Specialty clinic of infertility should be established at primary-level as soon as possible,to provide health education and related services for infertility patients,to spread the knowledge of physiology and health science to infertile couples,ensure early detection and early treatment.
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