授精时机和次数对夫精宫腔内人工授精临床结局的影响  

Effect of Timing and Number of Intrauterine Sperm Injection Per Cycle on the Outcomes of Artificial Insemination by Husband

作　　者：王亮[1] 路新梅[1] 孙宁霞[1] 章青[1] 徐晨[1] 曹燕[1] 李文[1] 

机构地区：[1]第二军医大学长征医院生殖医学中心,上海200003

出　　处：《生殖与避孕》2014年第11期902-907,共6页Reproduction and Contraception

摘　　要：目的:探讨授精时机和次数对夫精宫腔内人工授精(IUI)妊娠结局的影响。方法:选择在本中心行IUI的195例不孕患者共379个IUI周期,随机分成4组:于h CG注射后24 h行IUI,即排卵前单次授精组(A组,n=93)和排卵后单次授精组(B组,n=102);于h CG注射后48 h再次行IUI,即排卵前、后各行1次IUI的双次授精组(C组,n=84)和均在排卵前行IUI的双次授精组(D组,n=100)。分析精液处理后活动精子总数(processed total motile sperm,PTMS)、授精时机和次数与各组IUI周期妊娠率之间的关系。结果:当PTMS<5×106时,仅B组妊娠1例,其余各组未妊娠;当PTMS≥5×106时,各组妊娠率均有显著提高,B组周期妊娠率(32.22%)显著高于A组(14.12%)、C组(20.00%)和D组(17.39%)(P<0.05),A组、C组和D组之间周期妊娠率无统计学差异(P>0.05)。结论:PTMS≥5×106是IUI获得理想妊娠率的首要条件,h CG注射后24 h排卵后行单次授精可获得理想周期妊娠率,若此时仍未排卵患者行双次授精亦不能显著提高周期妊娠率。Objective： To study the effect of timing and number of intrauterine insemination （IUI） per cycle on the outcome of artificial insemination by husband （AIH）. Methods： A total of 195 infertile couples underwent 379 cycles of IUI with husband＇s sperm were collected. They were separated into 4 groups according to the timing and number of IUIs per cycle： single IUI was conducted 24 h after hCG injection, which was carried out before or after ovulation that was considered as group A and group B, respectively. Double IUI was conducted 24 h and 48 h after hCG injection, which was considered as group C that was carried out before ovulation firstly and after ovulation secondly, and group D was the double IUI which were done both before ovulation. The relationship between IUI pregnancy rate and the factors like processed total motile sperm （PTMS）, timing and number of IUI per cycle was analyzed. Results： When PTMS〈5 × 10^6, only group B had one pregnancy, the other groups had none. When PTMS ≥5 × 106, pregnancy rate in each group was improved significantly. The pregnancy rate in group B can reach to 32.22%, which was significantly higher than that in group A （14.12%）, group C （20.00%） and group D （17.39%）, respectively （P〈0.05）. Conclusion： IUI treatment is recommended to be performed when PTMS ≥ 5 × 10^6. The pregnancy rate would be satisfying by single IUI after ovulation 24 h after hCG injection, and if no ovulation, double IUI has no significant improvement in pregnancy rate compared with single IUI.

关 键 词：宫腔内人工授精(IUI) 处理后活动精子总数(PTMS) 授精时机 授精次数 妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]