929周期宫腔内夫精人工授精临床因素的分析  

Analysis of pregnancy outcomes in 929 cycles of intrauterine insemination

作　　者：李欣[1] 张军强[1] 武恂[1] 曹善仁[1] 李秀玲[1] 王培[1] 卢莹[1] 苏雁[1] 凌秀凤[1] 

机构地区：[1]南京医科大学附属南京市妇幼保健院生殖医学中心,江苏南京210004

出　　处：《中国妇幼健康研究》2011年第5期642-644,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的 比较不同治疗方案对宫腔内人工授精（IUI）结局的影响,分析影响人工授精妊娠率的相关因素.方法 回顾性分析2007年1月至2010年6月在南京市妇幼保健院生殖中心行人工授精治疗的795例患者929周期的治疗方案,从不孕症的原因、自然周期和促排卵周期、不同促排方案[克罗米酚（CC）组、克罗米酚＋人绝经期促性腺激素（hMG）组、人绝经期促性腺激素组、来曲唑组）、不孕年限、女方年龄以及人工授精周期数对妊娠率的影响并分别进行比较.结果 在795例患者中,有106例获得临床妊娠,临床妊娠率为13.33%,周期妊娠率为11.41%.男方因素组和排卵障碍组的临床妊娠率（14.32%、15.25%）明显高于其他因素组,不同病因组之间的妊娠率比较差异有统计学意义（χ2=13.050,P〈0.05）;自然周期与促排周期组的成熟卵泡数（1.03±0.18、1.15±0.39）具有显著性差异（t=-0.045,P〈0.01）,但是临床妊娠率（8.67%、12.71%）无显著性差异（P〉0.05）;在不同促排卵方案的选择上,克罗米酚＋人绝经期促性腺激素组及人绝经期促性腺激素组具有较高的妊娠率,与其他两组比较具有统计学差异（χ2=79.658,P〈0.05）;当不孕年限≥4年时,人工授精妊娠率明显下降（χ2=79.658,P〈0.05）;而女方年龄和人工授精周期数对人工授精结局的影响无显著性差异（P〉0.05）.结论 人工授精更适合于不孕年限〈4年或有排卵障碍的患者,以及由男方因素造成的不孕;同时,选择合适的促排卵方案可提高人工授精的临床妊娠率.Objective To compare the effects of different regimens on patients undergoing intrauterine insemination （IUI） and to analyze the influencing factors of pregnancy rate after IUI. Methods Based on retrospective analysis of treatment plans of 929 cycles for 795 patients undergoing IUI at the ART center of Nanjing Maternity and Child Health Hospital from January 2007 to June 2010, comparison of effects on pregnancy rate was made from the following perspectives： cause of infertility, natural and stimulating cycle, regimes of ovarian stimulation [ clomiphene citrate （CC） group, CC and human menopausal gonadotropin （hMG） group, hMG group, letrozole group ], infertility duration, woman＇s age and number of IUI cycles. Results 106 of 795 patients ended up in clinical pregnancy, and the clinical pregnancy rate and cycle pregnancy rate were 13.33% and 11.41% respectively. The clinical pregnancy rates of the male-party dominating factor group and ovulation barrier group （ 14.32% , 15.25% ） were significantly higher than those of other groups, and the difference in pregnancy rates of different groups was statistically significant （χ2 = 13. 050, P 〈0.05 ）. Significant difference in mature follicle numbers was found between natural cycle group and stimulating cycle group （ 1.03 ± 0. 18 vs 1.15 ± 0.39; t = - 0. 045, P 〈 0.01 ）, but the difference in clinical pregnancy rate （8.67%, 12.71% ） was not significant （P 〉0.05）. Compared with other two regimes, the pregnancy rates in CC ± （hMG） group and hMG group were relatively high, and the difference was statistically significant （χ2 = 79. 658 ,P 〈 0.05）. IUI pregnancy rate obviously declined （χ2 = 79.658, P 〈 0.05 ） when infertility duration was longer than 4 years. The effects of the woman age and number of IUI cycle on IUI outcomes were not obviously different （ P 〉 0.05 ）. Conclusion IUI is more suitable for patients with infertility duration less than 4 years or with ovulation barrier and infertility caused by

关 键 词：人工授精 妊娠率 影响因素 促排卵 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]