影响供精人工授精成功率的多因素分析  

Parameters Affecting the Pregnancy Rate in a Program of Artificial Insemination with Donor Sperm

作　　者：洪燕[1] 赵晓明[1] 孙赟[1] 徐冰[1] 叶梓[1] 

机构地区：[1]上海交通大学医学院附属仁济医院生殖医学中心,上海200001

出　　处：《生殖与避孕》2006年第7期403-407,共5页Reproduction and Contraception

摘　　要：目的:探讨多种因素对供精人工授精(AID)治疗效果的影响。方法:回顾性分析2004.12-2005.11期间在本中心579位妇女实施的1033个AID治疗周期,探讨AID治疗成功率与妇女年龄、输卵管治疗史、每周期AID治疗次数、AID实施周期数和授精方式的关系。结果:①35岁以上的不孕妇女AID治疗成功率明显下降(P<0.05);②有输卵管治疗史的妇女AID实施成功率低于正常妇女(P<0.05);③每周期施行2次人工授精的成功率高于单次的妇女(P<0.05);④AID实施1个直至5个周期每周期间的成功率无差异(P>0.05);⑤宫颈内和宫腔内人工授精的成功率无差异(P>0.05)。结论:不孕妇女的年龄、输卵管治疗史是影响AID治疗成功率的重要因素,同一周期进行2次宫颈内授精优于单次授精,无输卵管因素妇女的AID治疗在改用供精体外受精-胚胎移植前应至少可实施5个周期。在无宫颈因素的妇女中,同一周期2次宫颈内人工授精较宫腔内人工授精操作更简便,且成功率相似,可作为AID的首选。Objective： To establish the influence of the parameters affecting the pregnancy rate（PR） in a program of artificial insemination with donor sperm （AID） in those women without cervical factors. Methods： A total of 579 women with 1 033 treatment cycles were enrolled from December 2004 to November 2005. Retrospective analysis of the pregnancy rate （PR） and following factors are presented： the women＇s age, the treatment history of fallopian tube, the times of insemination per cycle, the numbers of treatment cycle and the method of inseminatioin. Results： 1） The PR after AID was significant lower in women older than 35 years （P〈0.05）; 2）The PR of women with treatment history of tube decreased significantly （P〈0.05）; 3） The women who performed insemination twice per cycle had higher PR than those performed once （P〈0.05）; 4） There was no difference in the PR of 1 to 5 treatment cycles （P〉0.05）; 5） Intrauterine insemination displayed the same PR with intracervical insemination （P〉 0.05）. Conclusion： Women age and the treatment history of fallopian tube had profound impacts on the cycle pregnancy rate. Twice insemination per cycle was benefit to PR than once insemination. The extension of treatment cycle of women with normal fallopian tube should increase to 5 cycles before treated by in-vitro fertilization and embryo transfer. Two intracervical insemination in one cycle can be the first choice of the AID treatment in those women without cervical factors, for perform more easy and display the same PR.

关 键 词：无精子症 供精人工授精 临床妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]