梗阻输卵管同侧卵巢排卵对宫腔内人工授精妊娠结局的影响  

Effect of ovulation from ipsilateral ovary of obstructed fallopian tube on the pregnancy outcome of intrauterine insemination

作　　者：司沙沙[1] 黎淑贞[1] 戢开丽[1] 娄娟[1] 黎平[1] SI Sha-sha;LI Shu-zhen;JI Kai-li;LOU Juan;LI Ping(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》2021年第10期1317-1322,共6页Journal of Reproductive Medicine

基　　金：江门市科技计划项目(江科【2018】123号-2018A048)。

摘　　要：目的探讨梗阻输卵管侧卵巢排卵对宫腔内人工授精(IUI)妊娠结局的影响。方法收集2018年3月至2020年8月于江门市中心医院生殖中心诊断为不孕症并接受IUI助孕患者的临床资料,共纳入533例患者,942个周期。根据梗阻输卵管与排卵卵巢的位置关系分为3组:梗阻输卵管同侧卵巢排卵(A组,74个周期);梗阻输卵管对侧卵巢排卵(B组,101个周期);双侧输卵管通畅、任意一侧卵巢排卵(C组,767个周期)。比较3组患者的一般情况(年龄、不孕年限、不孕类型、BMI、基础FSH、基础E 2、AMH、AFC)、周期资料(用药方案、排卵日内膜厚度和形态、精液处理后前向运动精子总数、IUI时机)、妊娠结局(临床妊娠率、异位妊娠率、早期自然流产率、活产率、继续妊娠率)。结果3组患者的年龄、不孕年限、不孕类型、BMI、基础FSH、基础E 2、AMH、AFC等一般情况相比较,差异均无统计学意义(P>0.05);3组患者的用药方案、排卵日内膜厚度和形态、精液处理后前向运动精子总数、IUI时机比较,差异均无统计学意义(P>0.05);A组、B组、C组的临床妊娠率分别为12.16%、13.86%、13.56%,异位妊娠率分别为0.00%、7.14%、2.88%,早期自然流产率分别为22.22%、14.29%、12.50%,活产率分别为9.46%、9.90%、9.78%,组间比较差异均无统计学意义(P>0.05)。结论梗阻输卵管同侧卵巢排卵的患者行IUI术后可获得与通畅输卵管侧卵巢排卵患者相似的妊娠结局。Objective:To explore the effect of ovulation from ipsilateral ovary of the obstructed fallopian tube on the pregnancy outcome of intrauterine insemination(IUI).Methods:The clinical data of 533 patients with 942 IUI cycles in the Reproductive Center of Jiangmen Central Hospital from March 2018 to August 2020 were collected.The cycles were divided into 3 groups according to the positional relationship between obstructed fallopian tube and ovulating ovary:group A:ovulation from ipsilateral ovary of the obstructed fallopian tube(n=74),group B:ovulation from contralateral ovary of the obstructed fallopian tube(n=101),and group C:bilateral fallopian tubes patency and ovulation from either ovary(n=767).General conditions[age,duration of infertility,type of infertility,BMI,basic FSH,basic E 2,AMH,antral follicle counting(AFC)],cycle data(medication regimen,thickness and morphology of endometrium on ovulation day,total progressive motility after semen treatment sperm count;IUI timing),pregnancy outcome(clinical pregnancy rate,ectopic pregnancy rate,early spontaneous abortion rate,live birth rate,continued pregnancy rate)were compared among the three groups.Results:There was no significant difference in age,infertile years,infertility type,BMI,basic FSH,basic E 2,AMH and AFC among the three groups(P>0.05).There were no significant differences in medication regimen,endometrial thickness and morphology on ovulation day,total number of forward motile sperm after semen treatment and IUI timing among the three groups(P>0.05).The clinical pregnancy rates of group A,group B and group C were 12.16%,13.86% and 13.56% respectively;the ectopic pregnancy rates were 0.00%,7.14%and 2.88% respectively;the early spontaneous abortion rates were 22.22%,14.29% and 12.50%respectively;and the live birth rates were 9.46%,9.90% and 9.78% respectively.There was no significant difference among the three groups(P>0.05).Conclusions:Patients who have ovulation from ipsilateral ovary of the obstructed fallopian tube can obtain a similar pregnancy outc

关 键 词：宫腔内人工授精 排卵 输卵管梗阻 临床妊娠率 

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