供精人工授精周期活产的影响因素分析  

Analysis of influence factors of live birth rate in artificial insemination with donor sperm

作　　者：倪丽莉[1] 王菁[1] 刁飞扬[1] 马翔[1] 张燕[1] 袁纯[1] 刘嘉茵[1] NI Li-li;WANG Jing;DIAO Fei-yang;MA Xiang;ZHANG Yan;YUAN Chun;LIU Jia-yin(Reproductive Medicine Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029)

机构地区：[1]南京医科大学第一附属医院生殖医学中心,南京210029

出　　处：《生殖医学杂志》2020年第10期1287-1292,共6页Journal of Reproductive Medicine

基　　金：江苏省青年基金(BK20191076);国家重点实验室开放课题(SKLRM-K201805);江苏省科教强卫工程项目(YXZXB2016001)。

摘　　要：目的探讨供精人工授精(AID)周期活产的影响因素。方法回顾性分析2012年1月至2018年12月于我中心接受AID助孕的1948对夫妇的4510个AID周期的临床资料。按助孕结局分为获得活产组(n=889)和未获活产组(n=3621),比较两组的女方基本资料及周期参数,采用多因素Logistic回归分析探索AID周期活产的影响因素,并应用ROC曲线确定各影响因素预测AID周期活产的临界值。结果AID周期活产率为19.71%(889/4510);与未获活产组相比,获得活产组女方较年轻[(27.76±3.13)岁vs.(28.32±3.42)岁]、孕前体重指数(BMI)较低[(21.51±2.60)kg/m^2 vs.(21.80±2.91)kg/m^2]、周期序号较小[(2.05±1.03)vs.(2.13±1.14)]、排卵日子宫内膜较厚[(10.01±2.11)mm vs.(9.81±2.04)mm](P均<0.05);Logistic回归分析显示女方年龄(OR=0.953,P<0.001)、孕前BMI(OR=0.966,P=0.012)、排卵日子宫内膜厚度(OR=1.049,P=0.008)、排卵前直径≥16 mm的卵泡数(OR=1.252,P=0.020)均显著影响AID周期活产率;根据ROC曲线,女方年龄、孕前BMI、排卵日子宫内膜厚度预测AID周期活产的临界值分别为30周岁、24.15 kg/m^2及10.3 mm。结论女方年龄、孕前BMI、排卵日子宫内膜厚度、排卵前直径≥16 mm的卵泡数是AID周期获得活产的独立预测因子。Objective:To investigate the influence factors of live birth rate in artificial insemination with donor sperm(AID).Methods:The clinical data of 4510 AID cycles in 1948 couples from January 2012 to December 2018 were retrospectively analyzed.According to AID outcome,the cycles were divided into live birth group(n=889)and non-live birth group(n=3621).The female basic data and cycle parameters were compared between the two groups.The influence factors of live birth rate in AID cycle were analyzed by multivariate logistic regression analysis,and the cutoff value of each influence factor to predict live birth in AID cycle was determined by using receiver operating characteristic(ROC)curve.Results:Live birth rate was 19.71%(889/4510).Compared with non-live birth group,live birth group had significantly younger women[(27.76±3.13)vs.(28.32±3.42)year],lower pre-pregnancy BMI[(21.51±2.60)vs.(21.80±2.91)kg/m^2],smaller cycle number[(2.05±1.03)vs.(2.13±1.14)]and thicker endometrium on ovulation day[(10.01±2.11)vs.(9.81±2.04)mm](all P<0.05).Logistic regression analysis showed that woman’s age(OR=0.953,P<0.001),pre-pregnancy BMI(OR=0.966,P=0.012),endometrial thickness on ovulation day(OR=1.049,P=0.008)and pre-ovulatory large follicle(≥16 mm)number(OR=1.252,P=0.020)significantly affected live birth rate in AID cycle.According to the ROC curves,the cutoff values of woman’s age,pre-pregnancy BMI and endometrial thickness on ovulation day to predict live birth were 30 years,24.15 kg/m^2 and 10.3 mm respectively.Conclusions:Woman’s age,pre-pregnancy BMI,endometrial thickness on ovulation day and number of follicles with diameter≥16 mm before ovulation are independent predictors of live birth in AID cycle.

关 键 词：供精人工授精 活产 孕前体重指数 子宫内膜厚度 

分 类 号：R714.8[医药卫生—妇产科学]