宫腔内人工授精临床妊娠率的影响因素分析  

Factors influencing the clinical pregnancy rate following intrauterine insemination

作　　者：刘文静[1] 李文涛[2] 张荣玲[1] 高建军[1] 王磊[1] 李月梅[1] 

机构地区：[1]潍坊市妇幼保健院,山东潍坊261011 [2]潍坊医学院,山东潍坊261053

出　　处：《中华男科学杂志》2015年第11期992-996,共5页National Journal of Andrology

摘　　要：目的:分析影响宫腔内人工授精(IUI)临床妊娠率的相关因素。方法:回顾性分析611个周期IUI者的临床资料,探讨女方年龄、不孕年限、不孕类型、所行周期数、周期方案、子宫内膜厚度及形态、处理前精液参数等因素与IUI妊娠率的关系。结果:促排卵周期妊娠率显著高于自然周期(23.03%vs 11.03%,P<0.01),第4周期以上的妊娠率较第1、2、3周期明显下降(2.04%vs 21.03%、18.13%、12.67%,P<0.01),当女方年龄≥40岁、处理前前向运动精子总数(TPMSC)<10×106、前向运动精子百分率<20%、正常形态精子百分率<2%时,IUI临床妊娠率明显下降(P均<0.05)。Logistic回归分析提示周期方案、所行周期数、前向运动精子百分率显著影响IUI临床妊娠率(P<0.05)。结论:周期方案、所行周期数、前向运动精子百分率、女方年龄、TPMSC以及精子形态是影响IUI临床妊娠率的重要因素,而不孕年限、不孕类型、子宫内膜厚度及形态对IUI成功率没有明显影响。Objective ： To investigate the factors that affect the clinical pregnancy rate after intrauterine insemination （IUI）. Methods ： We retrospectively analyzed the clinical data of 611 IUI cycles and analyzed the relationship of the clinical pregnancy rate after IUI with the female age, infertility duration, type of infertility, cycle number, cycle protocol, thickness and type of endometrium, and semen parameters before processing. Results ： The clinical pregnancy rate was significantly higher in the ovulation induction than in the natural ovulation cycles （23.03% vs 11.03% , P 〈0.01 ）, but lower in the 4th cycle and above than in the 1st, 2nd, and 3rd cycles （2.04% vs 21.30% , 18.13% , and 12.67% , P 〈0.01 ）. Marked decreases were found in the clinical pregnancy rate in the females aged ≥40 years and the cases with pre-processing total progressively motile sperm count （TPMSC） 〈 10 × 10^6, progressive motile sperm 〈 20% , or morphologically normal sperm 〈 2% （all P 〈 0.05 ）. I^gistic regression analysis revealed the cycle protocol, cycle number, and percentage of progressively motile sperm as three predictive variables affecting the clinical pregnancy rate after IUI （ P 〈 0.05 ）. Conclusion ： The cycle protocol, cycle number, percentage of progressively motile sperm, female age, TPMSC, and sperm morphology are the main factors affecting the clinical pregnancy rate following IUI, while infertility duration, type of infertility, and thickness and type of endometrium exert little influence.

关 键 词：人工授精 妊娠率 不孕 精子 

分 类 号：R714.8[医药卫生—妇产科学]