腹腔镜联合人工授精治疗子宫内膜异位症不孕的临床观察  

Clinic study on laparoscopic operation combined with intrauterine insemination treatment for endometriosis-associated infertility

作　　者：蒋亚玲[1] 邢福祺[1] 李冰[2] 全松[1] 冯健怀[2] 

机构地区：[1]南方医科大学南方医院生殖医学中心,广东广州510515 [2]广州医学院第三附属医院妇产科,广东广州510150

出　　处：《热带医学杂志》2011年第5期583-586,共4页Journal of Tropical Medicine

基　　金：广东省自然科学基金(5002464)

摘　　要：目的探讨子宫内膜异位症(EMs)不孕患者腹腔镜术后行夫精人工授精妊娠率的影响因素。方法回顾性分析164例腹腔镜术后的EMs不孕患者进行的318个人工授精周期的临床资料。以年龄、不孕年限、腹腔镜术后时间、用药情况、周期数、是否促排卵、r-AFS分期、IUI时机分别进行妊娠率的比较。结果 EMs不孕患者术后人工授精的周期妊娠率为13.21%。年龄≤35岁的周期妊娠率高于35岁以上者(χ2=6.687,P<0.05),不孕年限≤5年的妊娠率高于5年以上者(χ2=5.430,P<0.05),腹腔镜术后1年内行人工授精的妊娠率高于1年以上者(χ2=6.005,P<0.05),Ⅰ～Ⅱ期患者的妊娠率高于Ⅲ～Ⅳ期患者(χ2=8.264,P<0.05),加用促排卵治疗的妊娠率高于自然周期者(χ2=4.569,P<0.05),3周期内人工授精的妊娠率高于3周期以上者(χ2=4.031,P<0.05),双次IUI者妊娠率高于单次者(χ2=4.371,P<0.05),差异均有统计学意义。而术后是否使用GnRH-a则与妊娠率无关。结论 EMs不孕患者腹腔镜术后行人工授精治疗的最佳时间是术后1年内3周期内有较高的妊娠率,建议同时加用促排卵治疗。Objective To investigate factors affecting pregnancy rate of artificial insemination for endometriosis-associated infertile patients after laparoscopic operation.Methods 164 endometriosis-associated infertile patients after laparoscopic operation have received 318 cycles of intrauterine insemination（IUI）.Comparison of pregnancy rate are conducted on age,infertile time,controlled ovary hyperstimulation（COH）,r-AFS staging,medication,time and cycle number after operation and IUI frequency.Results Cycle pregnancy rate of IUI was 13.21%.Pregnancy rate of patients less than 35 years was higher than that of patients more than 35 years（x2=6.687,P0.05）.Pregnancy rate of patients with infertile time less than 5 years was higher than that of patients with intertile time more than 5 years（x2=5.430,P0.05）.Pregnancy rate of patients within 1 year after operation was higher than that of patients more than 1 year after operation（x2=6.005,P0.05）.Pregnancy rate of patients with Ⅰ～Ⅱ stage endometriosis was higher than that of patients with Ⅲ～Ⅳ stage（x2=8.264,P0.05）.Pregnancy rate of patients with COH was higher than that without COH（x2=4.569,P0.05）.Pregnancy rate within 3 IUI cycles is higher than that with more than 3 cycles（x2=4.031,P0.05）.Pregnancy rate of twice IUI per cycle is higher than that of once per cycle（x2=4.371,P0.05）.The differences were significant.Using GnRH-a after operation,however,did not affect pregnancy rate.Conclusion The best time to conduct IUI for endometriosis-associated infertile patients is within 1 year after operation.There is a higher pregnancy rate within first 3 cycles.COH is recommended.

关 键 词：子宫内膜异位症 不孕症 宫腔内人工授精 

分 类 号：R711.71[医药卫生—妇产科学]