前向运动精子数量对男性因素不孕者宫腔内人工授精临床妊娠率的影响  

Effect of progressive sperm count on clinical pregnancy rate of male factor couples undergoing intrauterine insemination treatment

作　　者：陆杉[1] 倪运萍[1] 刘娟[1] 王爱爱[1] 卢兴宏[1] 袁启龙[1] 周欢群[1] 冯妙芙[1] 

机构地区：[1]广东省中医院生殖医学科,广州510006

出　　处：《重庆医学》2014年第23期2991-2993,2996,共4页Chongqing medicine

基　　金：广东省医学科学技术研究基金(WSTJJ20111201652901197007211127)

摘　　要：目的探讨影响男性因素不孕宫腔内人工授精（IUI）妊娠率的相关因素。方法对167对不孕夫妇以男性因素为指征IUI治疗的302个周期的男性因素、男女双方年龄、不孕年限、原发或继发不孕、输卵管因素、是否促排卵、IUI治疗周期数、处理后前向运动精子数与妊娠率的关系进行分析。结果男性因素不孕者IUI累计临床妊娠率为24.0%（40/167）,其中弱精子症、畸精子症、少弱畸精子症、性功能障碍或精浆异常者妊娠率分别为11.7%、14.5%、13.7%、13.8%（P〉0.05）;女方年龄小于30岁、30-34岁、≥35岁者妊娠率分别为13.1%、12.3%、15.6%（P〉0.05）;男方年龄小于35岁、≥35岁者妊娠率分别为12.1%、15.0%（P〉0.05）;不孕年限小于3年、3-4年、≥5年者妊娠率呈下降趋势,分别为14.9%、12.7%、9.3%,但差异无统计学意义（P〉0.05）;原发性、继发性不孕者妊娠率分别为13.2%、13.2%（P〉0.05）;单侧、双侧输卵管通畅者妊娠率分别为16.5%、12.1%（P〉0.05）;自然周期、促排卵周期妊娠率分别为10.6%、15.9%（P〉0.05）。以处理后前向运动精子数5×106为界限,≥5×10^6者妊娠率14.8%,〈5×10^6者妊娠率2.6%,两组比较差异有统计学意义（P〈0.05）。而研究中将处理后前向运动精子总数分为小于或等于5×106,5×10^6-〈10×10^6,10×10^6-〈20×10^6,≥20×106共4组比较,妊娠率分别为2.6%、19.0%、15.5%、13.0%,差异无统计学意义（P〉0.05）;IUI治疗周期数1、2、3的妊娠率分别为14.4%、11.1%、15.8%（P〉0.05）,IUI治疗周期数大于或等于4妊娠率为0。结论处理后前向运动精子数是影响男性因素不孕IUI临床妊娠率的重要因素;IUI治疗周期数与妊娠率有关,超过3周期IUI无法提高临床妊娠率。Objective To investigate the influencing factors of clinical pregnancy rate of male factor couples undergoing intrauterine insemination（IUI）treatment.Methods 167 infertile couples in 302 cycles who underwent IUI treatment for male factors were collected.The correlation between pregnancy rate and following factors were analyzed：male factors,couples＇ age,duration of infertility,primary or secondary infertility,with or without tubal factors,ovulation induction or not,treatment cycles of IUI,motility of sperm after proceeding.Results The total clinical pregnancy rate of the cases collected was 24.0%（40/167）.The individual pregnancy rate of the different male factors were：athenospermia was 11.7%,teratospermia was 14.5%,oligoasthenotspermia was13.7%,sexual dysfunction and abnormal seminal plasma was 13.8%,there were no significant differences（P〈0.05）;The individual pregnancy rate compared with different female age were：less than 30 years old was 13.1%,between 30 and 34years old was12.3%,older than 35 years old was 15.6%,there were no significant differences（P〈0.05）;The individual pregnancy rate compared with different duration of infertility were：less than 3years was 14.9%,between 3and 4years was 12.7%,more than 5years was 9.3%,even there were no significant differences（P〈0.05）,it showed that there might be negative correlation between duration of infertility and pregnancy rate;Both of the pregnancy rate of primary infertility and secondary infertility were 13.2%,there were no significant differences（P〈0.05）;The individual pregnancy rate compared with unilateral and bilateral tubal patency were：unilateral was 16.5%,bilateral was 12.1%,there were no significant differences（P〈0.05）;The pregnancy rate of IUI with natural cycles was 10.6%,ovulation induction cycles was 15.9%,there were no significant differences（P〈0.05）;The pregnancy rate of progressive sperm count after proceeding more than≥5×106 was 14.8%,the count less than 5×106 was 2.6%,there were significant

关 键 词：不孕症 人工授精 男性因素不孕 临床妊娠 影响因素 

分 类 号：R714.8[医药卫生—妇产科学]