2140例不孕患者夫精宫腔内人工授精的临床效果及其影响因素  

Clinical effect and influencing factors of pregnancy after intrauterine insemination with the husband's sperm in 2 140 cases of infertile women

作　　者：朱娟[1,2] 马燕琳[1,2] 黄元华[1] 卢伟英[1] 张毅[1] 黄炜[1] 李崎[1] 羊在家[3] 

机构地区：[1]海南医学院附属医院,海口570102 [2]南方医科大学 [3]海南医学院管理学院

出　　处：《山东医药》2017年第19期1-4,共4页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(81460034);海南省重大科技项目(ZDZX2013003);海南省自然科学基金资助项目(812201);海南省哲学社会科学规划课题[(HNSK(QN)15-23]

摘　　要：目的观察2 140例不孕患者夫精宫腔内人工授精(IUI)的临床效果,并分析其影响因素。方法 2 140例不孕患者,均行IUI治疗,共治疗3 383个IUI周期,采用B超测量HCG日患者子宫内膜厚度,计算直径≥14 mm卵泡数。IUI后第30天计算临床妊娠率、抱婴率、流产率、异位妊娠率、多胎妊娠率。分析IUI的临床妊娠率、抱婴率与不孕症患者年龄、不孕类型、不孕原因、IUI次数的关系。结果 3 383个IUI周期中患者HCG日子宫内膜厚度(9.4±2.0)mm,直径≥14 mm卵泡数(2.6±1.9)个。IUI后第30天时临床妊娠率15.0%(508/3 383),抱婴率11.1%(375/3 383)。流产率16.9%(86/508),异位妊娠率8.9%(45/508),其中宫内妊娠合并宫外妊娠者4例、双胎妊娠58例、三胎妊娠8例、四胎妊娠3例,多胎妊娠率13.6%(69/508)。女性年龄>40岁者临床妊娠率、抱婴率明显低于其余年龄者,P均<0.05。原发不孕与继发不孕患者的临床妊娠率分别为14.8%(285/1 921)、15.3%(223/1 462),抱婴率分别为10.9%(209/1 921)、11.4%(166/1 462),二者比较,P均>0.05。39~40岁原发不孕患者抱婴率明显低于继发不孕者,P<0.05。女性因素不孕患者临床妊娠率、抱婴率均低于混合因素者,P均<0.05。不同IUI周期次数之间临床妊娠率与抱婴率间比较差异无统计学意义。结论 IUI的成功率仍较低,女性年龄<40岁、提高IUI周期次数是提高IUI妊娠结局的重要因素,临床中应综合分析女性年龄、不孕类型、不孕原因选择合适助孕方案。Objective To observe the clinical effect of intrauterine insemination （IUI） with the husband＇s sperm on pregnancy in 2 140 cases of infe^ile women, and to analyze its influencing factors. Methods Totally 2 140 cases of infer- tility women treated with IUI for 3 383 ovulation-promoting cycles of intrauterine insemination with the husband＇s sperm were retrospectively analyzed. We used B ultrasound to Calculated HCG day＇s follicles with diameter I〉 14 mm and to meas- ure the endometrial thickness. Thirty days after IUI, the clinical pregnancy rate, delivery rate, abortion rate, ectopic preg- nancy rate, and multiple pregnancy rate were calculated. The correlations between clinical pregnancy rate, delivery rate, and the following factors, including infertile patients＇ age, type of infertility, indications, and times of IUI, were analyzed. Results In the 3 383 IUI cycles, the mean number of HCG day＇s follicles with diameter ≥ 14 mm was （2.6 ± 1.9）, and the mean endometrial thickness was （9.4 ± 2.0） mm. Thirty days after IUI, the clinical pregnancy rate was 15.0% （508/ 3 383）, and delivery rate was 11.1% （375/3 383）. The abortion rate was 16.9% （86/508）. Ectopic pregnancy rate was 8.9% （45/508）, including 4 cases of heterotopic pregnancy, 58 cases of twin pregnancy, 8 cases of triplet pregnancy, 3 cases of quadruplet pregnancy, and the multiple pregnancy rate was 13.6% （69/508）. The group of women with age 〉 40 mm years had significantly lower clinical pregnancy rate and delivery rate than the other groups （ all P 〈 0. 05 ）. The clini-cal pregnancy rates of patients with primary and secondary infertility were 14.8% （285/1 921 ） and 15.3% （223/1 462）, and the delivery rates were 10.9% （209/1 921 ） and 11.4% （ 166/1 462）, respectively （ all P 〉 0.05 ）. In 39 to 40 years old women, the delivery rate of patients with primary infertility was significantly lower than that of patients with sec- ondary infertility （ P 〈 0.05 ）. The clinical pre

关 键 词：不孕症 宫腔内人工授精 夫精人工授精 人工授精 临床妊娠率 抱婴率 

分 类 号：R711.6[医药卫生—妇产科学]