供精人工授精夫妇周期妊娠率的影响因素及心理创伤分析  

Analysis of pregnancy outcomes and psychological trauma in couples undergoing artificial insemination by donor

作　　者：蔡雪芬 孙艳[1] 余爱丽[1] 李榕珊 林隽祺 郑备红[1] CAI Xue-fen;SUN Yan;YU Ai-li;LI Rong-shan;LIN Jun-qi;ZHENG Bei-hong(Reproductive Medicine Center,Fujian Provincial Maternity and Children’s Hospital,Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属福建省妇幼保健院生殖中心,福州350001

出　　处：《创伤与急诊电子杂志》2019年第4期205-211,共7页Journal of Trauma and Emergency(Electronic Version)

基　　金：国家重点研发计划项目(2018YFC1002105);福建省自然科学基金计划项目(2019J01513)。

摘　　要：目的探讨供精人工授精(artificial insemination by donor,AID)影响妊娠率的临床因素和AID夫妇的心理特征。方法回顾性分析2015年1月至2018年12月在福建省妇幼保健院生殖中心门诊接受AID治疗的夫妇660对临床资料,共1305个AID周期。对女方年龄、不孕年限、体重指数(body mass index,BMI)、不孕类型、治疗方案、子宫内膜厚度、授精方式、同一周期AID次数、治疗周期数与AID妊娠率进行χ2检验和二分类Logistic回归分析,探索各临床因素与AID妊娠率的关系。采用生育压力量表(fertility problem inventory,FPI)和生活质量量表(FertiQoL量表)对2018年1月至2018年12月在福建省妇幼保健院生殖中心门诊接受AID治疗的130对夫妇进行心理创伤调查,比较夫妇双方生育压力和生活压力的差异。结果<25岁[31.7%(51/161)]、25~35岁女性[22.8%(244/1072)]和>35岁[19.4(14/72)]女性周期妊娠率差异有统计学意义(χ2=6.913,P=0.032);不孕年限≤5年和>5年的女性之间妊娠率差异有统计学意义(24.8%比18.6%,χ2=4.248,P=0.039);宫腔内人工授精(intrauterine insemination,IUI)的妊娠率(26.2%)明显高于颈管内人工授精(intracervical insemination,ICI)女性(15.6%),差异有统计学意义(χ2=14.912,P<0.010)。二分类Logistic回归分析显示授精方式是影响AID周期妊娠率的主要因素,IUI周期妊娠率较ICI高(OR=2.028,95%CI 1.458~2.822,P<0.010)。AID女性FPI总分高于配偶[(175.00±8.11)分比(168.68±6.86)分,t=6.295,P<0.010],女性在夫妻关系[(36.08±4.77)分比(34.67±4.74分),t=2.502,P=0.014]、无子女压力[(28.91±3.38)分比(26.91±3.18)分,t=6.530,P<0.010]维度的得分亦高于配偶;AID女性FertiQoL总分低于配偶[(55.96±6.57)分比(62.30±6.84)分,t=-8.582,P<0.010],女性在环境[(50.46±9.51)分比(55.01±9.01),t=-4.149,P<0.010]、耐受性[(51.55±6.17)分比(56.29±6.48)分,t=-5.657,P<0.010]、情感反应[(54.92±5.92)分比(59.85±6.79)分,t=-5.736,P<0.010]、婚姻关系[(58.15±6.71)分比Objective To analyze the influence factors on the pregnancy outcomes and psychological trauma in couples undergoing artificial insemination by donor(AID).Methods A retrospective analysis was performed on the pregnancy outcomes of 660 infertile couples undergoing AID for 1305 cycles between January 2015 and December 2018 in our Reproductive Medicine Center of Fujian Provincial Maternity and Children’s Hospital.Women’s age,duration of infertility,body mass index(BMI),type of infertility,treatment protocol,endometrial thickness,AID operative approaches,number of insemination per cycle and the number of assisted reproductive cycle was analyzed byχ2 and binary Logistic regression to explore the relationship between the clinical factors and pregnancy outcomes in AID.The cross-sectional survey was carried out in 130 infertile couples who underwent AID between January 2018 and December 2018 in our center using the Fertility Question Inventory(FPI)scale and the Fertility Quality of Life(FertiQoL)scale.A paired t-test was utilized to explore the fertility stress and life quality in husband and wife.Results The clinical pregnancy rate in the women younger than 25 years of age(31.7%)and those aged 25~35 years(22.8%)was significantly higher than that in those older than 35 years of age(19.4%)(χ2=6.913,P=0.032).Compared with those with infertility duration≤5 years,the pregnancy rate of the women with infertility duration>5 years decreased significantly(24.8%vs 18.6%,χ2=4.248,P=0.039).The pregnancy rate was significantly higher in intrauterine insemination(IUI)group(26.2%)than that in intracervical insemination(ICI)group(15.6%)(χ2=14.912,P<0.010).Multivariate Logistic regression showed that the AID operative approach was an important factor affecting the pregnancy rate of AID(OR=2.028,95%CI 1.458~2.822,P<0.010).The total score of fertility stress in wives were higher than that in husbands[(175.00±8.11)vs(168.68±6.86),t=6.295,P<0.010].The social stress[(36.08±4.77)vs(34.67±4.74),t=2.502,P=0.014]and the childless st

关 键 词：供精人工授精 宫腔内人工授精 宫颈管内人工授精 周期妊娠率 生育相关压力 生活质量 

分 类 号：R714.8[医药卫生—妇产科学]