宫腔内人工授精治疗子宫内膜异位症不孕临床效果的影响因素分析  

Clinical study on treatment of intrauterine insemination for endometriosis complicated with infertility

作　　者：苏宁[1] 夏薇[1] 王维[1] 曾艳华[1] 

机构地区：[1]广东省广州市第一人民医院生殖健康与不孕症专科,510180

出　　处：《中国计划生育学杂志》2014年第9期606-609,613,共5页Chinese Journal of Family Planning

基　　金：广州市卫生局资助项目(20131A011019)

摘　　要：目的：探讨宫腔内人工授精（IUI）治疗子宫内膜异位症（（EMS）不孕临床效果的影响因素.方法：收集2008年1月～2014年1月在本科就诊的100例EMS不孕患者205周期IUI资料,比较EMS生育指数（EFI）和IUI术前促性腺激素释放激素激动剂（GnRH-a）预处理（GnRH-a组112周期,非GnRH-a组93周期）及治疗方案[自然周期组11周期,促排卵周期组194周期;促性腺激素（Gn）组139周期,非Gn组55周期]对临床妊娠率的影响.结果：EFI≥9分的EMS不孕患者IUI妊娠周期率及累积妊娠率分别为21.1％和40.0％,显著高于EFI≤8分的患者（分别为9.3％和20.0％）,差异均有统计学意义（P＜0.05）;自然周期组与促排卵周期组周期妊娠率分别为0和14.4％;GnRH-a组与非GnRH-a组周期妊娠率分别为16.1％和10.8％,差异无统计学意义（P＞0.05）;Gn组与非Gn组周期妊娠率分别为15.8％和10.9％,双胎妊娠率分别为13.6％和16.7％,差异均无统计学意义（P＞0.05）.结论：EFI≥9分的EMS不孕患者腹腔镜术后应积极采用IUI助孕治疗,IUI治疗前不建议使用GnRH-a等药物进行预处理,促排卵联合IUI可以提高患者的妊娠几率.Objective：To explore the relative factors affecting the clinical pregnancy rate of intrauterine insemination （IUI） for the treatment of infertility caused by endometriosis.Methods：The clinical data of 100 endometriosis patients complicated with infertility undergoing 205 IUI cycles during Jan.2008 to Jan.2014 were analyzed.The influences of endometriosis fertility index （EFI）,gonadotropin releasing hormone analogues （GnRH--a） and the different regimen for ovulation on the clinical pregnancy rate of IUI were investigated.Results：The clinical pregnancy rate and the cumulative pregnancy rate were 21.1％ and 40.0％ in patients with EFI≥9,significantly higher than those of patients with EFI≤8 （9.3％ and 20.0％,respectively,P＜0.05） ; The clinical pregnancy rate was 14.4％ in ovarian stimulation cycles and 0 in natural cycles; The clinical pregnancy rates of patients receiving and no receiving GnRH-a therapy before IUI were 16.1％ and 10.8 ％,respectively （P＞0.05）; The clinical and twin pregnancy rates of patients with gonadotropin （Gn） ovulation were 15.8％ and 13.6％ respectively,which was 10.9％ and 16.7％ with other regimen for ovulation,showing no statistically significant differences （P all ＞0.05）.Conclusions：The patients with EFI≥9 should receive IUI therapy after laparoscopic operation as soon as possible,GnRH-a pretreatment before IUI is not recommended,and the combination of ovulation and IUI could increase the pregnancy rate.

关 键 词：宫腔内人工授精 子宫内膜异位症 不孕 子宫内膜异位症 生育指数 

分 类 号：R714.8[医药卫生—妇产科学]