女性年龄对夫精宫腔内人工授精结局的影响  

Influence of women's age on the pregnancy outcome of intrauterine insemination with husband's sperm in ovulation-promoting cycle

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

机构地区：[1]海南医学院第一附属医院生殖中心,海南海口570102 [2]南方医科大学,广东广州510515 [3]海南医学院管理学院,海南海口571199

出　　处：《海南医学》2017年第17期2796-2799,共4页Hainan Medical Journal

基　　金：国家自然科学基金(编号:81460034);海南省重大科技项目(编号:ZDZX2013003);海南省自然科学基金(编号:812201)

摘　　要：目的分析不同年龄组促排卵周期夫精宫腔内人工授精(IUI)的临床结局及其影响因素。方法回顾性分析2008年1月至2015年12月期间在海南医学院第一附属医院生殖中心进行促排卵周期IUI治疗的4 228个周期的临床资料,分析临床妊娠率、抱婴率、流产率与女性年龄的关系。结果 IUI临床妊娠率为14.5%(614/4 228),抱婴率为10.1%(429/4 228),流产率为15.5%(95/614);按照女性年龄分为21~25岁组、26~30岁组、31~35岁组、36~38岁组、39~40岁组、>40岁组,各组临床妊娠率依次分别为16.5%(40/242)、16.8%(262/1 559)、14.2%(224/1 578)、13.1%(59/451)、8.9%(18/203)、5.6%(11/195);其抱婴率依次分别为10.3%(25/242)、12.2%(190/1 559)、10.2%(161/1 578)、8.4%(38/451)、4.9%(10/203)、2.6%(5/195);其流产率依次分别为7.5%(3/40)、14.1%(37/262)、13.4%(30/224)、25.4%(15/59)、27.8%(5/18)、45.5%(5/11);各年龄组临床妊娠率、抱婴率、流产率比较差异均有显著统计学意义(P<0.01);HCG日子宫内膜厚度平均(9.4±2.0)mm,各组的子宫内膜厚度比较差异无统计学意义(P>0.05);各组平均处理后前向运动精子数依次分别是(11.7±12.3)百万、(10.4±10.8)百万、(9.9±9.4)百万、(10.2±10.6)百万、(8.9±10.0)百万,各组比较差异均无统计学意义(P>0.05);各组的不孕年限依次分别为(3.5±1.5)年、(4.3±2.1)年、(5.2±2.7)年、(6.3±3.8)年、(6.3±4.6)年、(6.2±5.2)年;IUI次数依次分别为(1.4±0.6)次、(1.5±0.8)次、(1.6±0.8)次、(1.6±0.8)次、(1.6±0.9)次、(1.7±1.2)次;直径≥14 mm卵泡个数依次分别为(2.8±2.1)个、(2.7±2.1)个、(2.5±1.9)个、(2.5±1.8)个、(2.4±1.6)个、(2.3±1.4)个;不孕年限、IUI次数、直径≥14 mm的卵泡个数总体分布不全相同,差异均有显著统计学意义(P<0.01)。结论年龄是影响AIH结局的重要因素,对于年龄较大的患者特别是>40岁者应慎重选择IUI,适当减少IUI次数。Objective To investigate the effect of women＆#39;s age on the pregnancy outcomes of intrauterine in-semination with husband＆#39;s sperm in ovulation-promoting cycle. Methods The clinical data of 4228 ovulation-promot-ing cycles of intrauterine insemination with the husband＆#39;s sperm which performed in the Reproductive Center of the First Affiliated Hospital of Hainan Medical University from January 2008 to December 2015 were collected and retrospective-ly analyzed. The correlations between clinical pregnancy rate, delivery rate, miscarriage rate and women＆#39;s age were ana-lyzed. Results The overall clinical pregnancy rate, delivery rate and miscarriage rate were 14.5%（614/4228）, 10.1%（429/4228）, and 15.5%（95/614）, respectively. According to the women＆#39;s age, the cycles were divided into the follow-ing groups：21-25 years group, 26-30 years group, 31-35 years group, 36-38 years group, 39-40 years group, over 40 years group. The clinical pregnancy rates of the different age groups were 16.5%（40/242）, 16.8%（262/1559）, 14.2%（224/1578）, 13.1% （59/451）, 8.9% （18/203） and 5.6% （11/195）, respectively; the delivery rates were 10.3% （25/242）, 12.2%（190/1559）, 10.2%（161/1578）, 8.4%（38/451）, 4.9%（10/203） and 2.6%（5/195）, respectively;the abortion rates were 7.5% （3/40）, 14.1% （37/262）, 13.4% （30/224）, 25.4% （15/59）, 27.8% （5/18）, 45.5% （5/11）, respectively. There were statistically significant differences in the clinical pregnancy rate, delivery rate and miscarriage rate between the dif-ferent age groups （P〈0.01）. The average endometrial thickness of HCG day was （9.4±2.0） mm, and there was no statisti-cal difference in the endometrial thickness between the different age groups （P〉0.05）. The average progressive sperms＆#39; count （millions） of the different age groups were （11.7 ± 12.3） millions, （10.4 ± 10.8） millions, （9.9 ± 9.4） millions, （10.2 ± 10.6） millions, （8.9±10.0） mil

关 键 词：宫腔内人工授精(IUI) 临床妊娠率 抱婴率 流产率 妊娠结局 

分 类 号：R715[医药卫生—妇产科学]