促排卵对宫腔内人工授精周期妊娠结局的影响  

Effects of ovarian induction on pregnant outcomes in intrauterine insemination

作　　者：陈秀敏[1] 朱文杰[1] 刘锦[1] 张晓霞[1] 石嵩[1] 张婉菁[1] 

机构地区：[1]深圳市妇幼保健院生殖健康科,518000

出　　处：《中国优生与遗传杂志》2013年第6期107-109,98,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的比较不同病因、年龄组促排卵周期和自然周期人工授精临床妊娠率和流产率差异,分析促排卵对宫腔内人工授精周期结局的影响。方法回顾性分析我院生殖科2006年1月～2011年12月1224个人工授精周期,根据病因、年龄、HCG日大卵泡数分组,比较各组内促排卵周期与自然周期临床妊娠率和流产率的差异。结果①促排卵周期人工授精妊娠率为17.7%,自然周期妊娠率为11.3%(P<0.05),有统计学差异;两组流产率无差异(15.4%,25.3%,P>0.05)。②促排卵周期中,氯米芬和HMG周期妊娠率分别为16.4%,18.2%;流产率分别为:25.0%,14%,差异均无统计学意义(P>0.05)。③年龄>35岁与<35岁比较妊娠率无差异(13.2%,13.4%,P>0.05),流产率显著增加(35%,15.1%,P<0.00)。年龄<35岁,OI周期妊娠率明显高于自然周期(17.6%,9.7%,P<0.05)。OI周期和自然周期流产率在不同年龄组均无差异。④促排卵周期中,排卵障碍组、不明原因不孕组的妊娠率(30.7%,28.1%)高于自然周期(21.7%,8.3%),差异有统计学意义。宫颈因素、男性因素、双方因素、子宫内膜异位症不孕患者,促排卵治疗妊娠率(11.3%,12.5%,9.8%,17.1%)与自然周期(11.3%,11.2%,8.3%,9.5%)相似,差异无显著意义。心理障碍组自然周期妊娠率(47.4%)高于促排卵周期(33.3%)(P<0.05)。⑤促排卵周期,HCG日单卵泡组妊娠率为16.7%,多卵泡组19.0%,差异无显著性(P>0.05)。结论促排卵周期妊娠率高于自然周期,不增加流产率。以不明原因不孕及排卵障碍行IUI治疗者,促排卵治疗可增加妊娠率,对于男性因素、子宫内膜异位症或年龄大于35岁患者促排卵不增加妊娠率。Objective：To evaluate the effects of ovarian induction（OI） on pregnant outcomes in intra-uterine insemination（IUI）.Methods：1224 IUI cycles from Jan 2006 to Dec 2011 were included,consist of 811 nature cycles（NC） and 413 ovarian induction cycles（OIC）.Clinic pregnancy rates（PR）,miscarriage rates（MR） were compared between OI and nature cycles.Results：①PRs were significantly higher in OIC than NC（17.7%,11.3%,P0.05）,The rates of MRs had no significant differences between the two groups.②PRs and MRs of CC cycles are comparable with HMG cycles.③Women older than 35y had similar PRs（13.2%,13.4%,P0.05）,but showed higher MRs than younger women（35%,15.1%,P0.00）.④In OIC,clinical PRs were significantly higher than NC in patient with unknown reason infertility and ovulatory disorders（28.1%,8.3%;30.7%,21.7%;P0.05）.The clinical PRs were comparable in OIC and NC in couples with semen defects,endometriosis,cervical factor and aged women.But for psychological factor,NC was better than OIC（47.4%,33.3%,P0.05）.⑤The influence of the number of follicles on PRs（16.7%,19.0%,P0.05） in intrauterine insemination with OI could be ignored.Conclusions：The OIC could achieve a higher pregnancy rate than NC in IUI,whether CC or HMG,especially for the infertile patients with unknown reason infertility and ovulatory disorders.There is no difference in MRs between OI and NC.OIC should be cautious for those groups with semen defects,endometriosis,cervical factor and more than 35y.

关 键 词：宫腔内人工授精(IUI) 自然周期 促排卵周期 妊娠率 流产率 

分 类 号：R714.8[医药卫生—妇产科学]