宫腔内夫精人工授精不孕患者自然周期与促排卵周期临床妊娠结局分析  

Analysis of clinical pregnancy outcomes of infertile patients undergoing natural cycles and stimulate ovulation cycles of intrauterine artificial insemination by husband

作　　者：李雪丽 潘宇 陈芳 吕芳 刘凯峰 董乃俊 张晓梅 

机构地区：[1]扬州大学临床医学院苏北人民医院生殖医学中心,江苏225001

出　　处：《中华妇幼临床医学杂志（电子版）》2017年第4期409-413,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金资助项目(81100421;81601343);江苏省六大人才高峰项目(2014-WSW-080);扬州市自然科学基金资助项目(YZ2014050;YZ2016110)~~

摘　　要：目的探讨不孕患者接受自然周期与促排卵周期,宫腔内夫精人工授精(AIH)的临床妊娠结局。方法选择2010年1月至2015年12月,在苏北人民医院生殖医学中心,接受AIH治疗的不孕患者共计2 664个周期为研究对象。按照采用的子宫内膜准备方案,将其中1 557个自然周期,纳入自然周期组,1 107个促排卵周期,纳入促排卵周期组。回顾性分析2组不孕患者临床病例资料。统计学比较2组不孕患者一般临床资料,临床妊娠结局,以及2组间不同年龄不孕患者的临床妊娠结局。结果(1)2组患者的年龄、不孕年限、血清雌激素浓度、血清卵泡刺激素(FSH)及血清促黄体激素(LH)水平、体重、窦卵泡数,以及原发不孕、继发不孕及单侧输卵管阻塞比例比较,差异均无统计学意义(P>0.05)。(2)自然周期组不孕患者多胎妊娠率较促排卵周期组低,并且差异有统计学意义(χ~2=4.521,P=0.033);2组不孕患者的临床妊娠率、活产率、自然流产率及异位妊娠率比较,差异均无统计学意义(P>0.05)。(3)2组间<35岁不孕患者的临床妊娠率、多胎妊娠率分别比较,以及2组间≥35岁不孕患者的临床妊娠率、多胎妊娠率分别比较,差异均无统计学意义(P>0.05)。结论对于采用AIH助孕的不孕患者,促排卵周期可能并不能提高患者的临床妊娠率,反而会增加多胎妊娠率。Objective To explore the clinical pregnancy outcomes of infertile patients with natural cycles or stimulate ovulation cycles of intrauterine artificial insemination by husband（AIH）.Methods A total of 2 664 cycles of infertile patients who received AIH in Reproductive Medicine Center of Northern Jiangsu People′s Hospital from January 2010 to December 2015,were chosen as study subjects.According to the application of endometrial preparation,1 557 natural cycles were included in the natural cycle group,and 1 107 stimulate ovulation cycles were included in the stimulate ovulation cycle group.The clinical medical records of two groups of infertile patients were retrospectively analyzed.The general clinical data and clinical pregnancy outcomes between two groups of infertile patients were compared statistically,and the clinical pregnancy outcomes of infertile patients in different ages between two groups were compared too.Results（1） There were no significant differences between two groups of infertile patient in age,infertility duration,serum concentration of estrogen,serum follicle stimulating hormone（FSH）level and serum luteinizing hormone（LH）level,body weight,sinus ovarian follicle number,and the proportion of primary infertility,secondary infertility and hemi-fallopian tube obstruction（P〈0.05）.（2） The multiple pregnancy rate of natural cycle group was lower than that of stimulate ovulation cycle group,and the difference was statistically significant（χ~2=4.521,P=0.033）.There were no significant differences between two groups in clinical pregnancy rate,live birth rate,miscarriage rate and ectopic pregnancy rate（P〈0.05）.（3） There were no significant differences between two groups of infertile patients of35 years old or≥35years old in clinical pregnancy rate and multiple pregnancy rate,respectively（P〈0.05）.Conclusions For infertile patients with AIH,stimulate ovulation cycle may not improve clinical pregnancy rate but may increase the multiple pregnancy rate.

关 键 词：排卵诱导 授精 人工(丈夫供体) 生殖技术 辅助 不育 自然周期 女(雌)性 

分 类 号：R714.8[医药卫生—妇产科学]