单侧输卵管异常对宫腔内人工授精妊娠结局的影响  

Effect of unilateral fallopian tube abnormality on pregnancy outcome of intrauterine insemination

作　　者：李云 黎平[1] 黎淑贞[1] 陈希曦[1] 郭江华[1] 梁辉洪[1] LI Yun;LI Ping;LI Shu-zhen;CHEN Xi-xi;GUO Jiang-hua;LIANG Hui-hong(The Reproduction Medical Center of Jiangmen Center Hospital,Jiangmen 529030)

机构地区：[1]广东省江门市中心医院,江门529030

出　　处：《生殖医学杂志》2020年第8期1039-1043,共5页Journal of Reproductive Medicine

摘　　要：目的探讨单侧输卵管异常患者输卵管不同异常情况及不同侧排卵对宫腔内人工授精(IUI)妊娠结局的影响。方法回顾性分析2018年3月至2019年11月在我院生殖中心进行IUI治疗的615例不育症患者(共1252个周期)的临床资料。根据不同情况将纳入周期分为3组:A组:单侧输卵管异常且仅输卵管异常侧卵巢有优势卵泡的周期(n=149);B组:单侧输卵管异常且通畅侧卵巢有优势卵泡的周期(n=216);C组:双侧输卵管均通畅的周期(n=887)。A组又分为3个亚组:A1组:输卵管近端阻塞,仅阻塞侧卵巢有优势卵泡(n=71);A2组:输卵管远端阻塞,仅阻塞侧卵巢有优势卵泡(n=24);A3组:仅输卵管通而不畅侧卵巢有优势卵泡(n=54)。比较各组患者的一般资料及妊娠结局。结果A、B、C三组的临床妊娠率比较有C组>B组>A组的趋势,但尚无显著性差异(P>0.05);A组和B组的异位妊娠率均有高于C组的趋势,亦无显著性差异(P>0.05)。A1、A2、A3三组比较,A1组的平均年龄显著高于A2、A3组(P<0.05);临床妊娠率组间比较,有A1组>A3组>A2组的趋势,但尚无显著性差异(P>0.05);3组间异位妊娠率比较亦无显著性差异(P>0.05)。结论对于单侧输卵管异常的患者,当通畅侧卵巢有优势卵泡时,对侧输卵管异常可能对IUI妊娠结局影响不大。当仅输卵管异常侧有优势卵泡时,若异常情况为近端阻塞,可继续行IUI;若异常情况为通而不畅或远端梗阻时,应慎重考虑是否继续本周期IUI。Objective:To investigate the effects of different abnormalities of the fallopian tube and the ovulation of different sides on the pregnancy outcome of intrauterine insemination(IUI)in patients with unilateral tubal abnormalities.Methods:The clinical date of 1252 cycles of 615 patients who underwent IUI in our reproduction center from March 2018 to November 2019 were analyzed retrospectively.According to different condition,the cycles were divided into three groups:group A:unilateral tubal abnormality and only the ovary on abnormal tube had dominant follicles(n=149);group B:unilateral tubal abnormalities and the ovary on the unobstructed tube side had dominant follicles(n=216);group C:Both fallopian tubes were unobstructed(n=887).The cycles of group A were then divided into three subgroups:group A1:proximal obstruction of tube and the only ovary on the side of abnormal tube had dominant follicles(n=71);group A2:distal obstruction of tube and the ovary on the side of abnormal tube had dominant follicles(n=24);A3:the ovary on the side of incomplete blocked tube had dominant follicles(n=54).The baseline conditions and pregnancy outcomes were compared among the groups.Results:The clinical pregnancy rates of the three groups had a tendency of group C>group B>group A,but the difference was not significant(P>0.05).The ectopic pregnancy rate of group A and group B was higher than group C,but the difference was not significant(P>0.05).The age in group A1 was significantly higher than that in group A2 and A3(P<0.05).The clinical pregnancy rates of the three groups had a tendency of group A1>group A3>group A2,but the difference was not significant(P>0.05).The ectopic pregnancy rate was not significantly different among the three groups(P>0.05).Conclusions:For patients with unilateral tubal abnormalities,when the ovary on unobstructed has dominant follicles,the contralateral tubal abnormalities may have little effect on IUI pregnancy outcomes.When only the ovary on the side of abnormal fallopian tube has a dominant follicle,I

关 键 词：宫腔内人工授精 单侧输卵管异常 妊娠率 

分 类 号：R711.6[医药卫生—妇产科学] R711.76[医药卫生—临床医学]