单次与双次宫腔内人工授精对不孕症患者妊娠结局影响的Meta分析  

Meta-analysis of the effect of single and double intrauterine insemination on pregnancy outcome in infertile patients

作　　者：陈佳运 朱琴[1] 朱加娟 张宇虹 包晓燕[1] 狄春光 CHEN Jia-yun;ZHU Qin;ZHU Jia-juan;ZHANG Yu-hong;BAO Xiao-yan;DI Chun-guang(Jiaxing Maternity and Child Health Care Hospital,Jiaxing 314000)

机构地区：[1]嘉兴市妇幼保健院,嘉兴314000

出　　处：《生殖医学杂志》2023年第2期269-275,共7页Journal of Reproductive Medicine

基　　金：浙江省基础公益研究计划项目(GF21H040027)。

摘　　要：目的采用Meta分析方法系统评价单次与双次宫腔内人工授精(IUI)对不孕症患者妊娠结局的影响。方法检索中国知网(CNKI)、维普(VIP)、万方(WanFang)、PubMed、Cochrane图书馆、Ebase数据库,搜集单次与双次IUI对不孕症患者妊娠结局影响的随机对照试验(RCTs)文献,检索时段从数据库建立到2022年5月。所有文献均由两位评价者根据纳入标准和排除标准分别选取、提取临床相关数据,并对文献质量进行评价,采用RevMan 5.4软件进行Meta分析。结果共13篇RCTs文献被纳入本研究,分析结果显示:对于轻度少精或弱精子症患者,双次IUI能显著提高患者临床妊娠率(P<0.0001);但对于精液质量正常和精液质量不明的患者,双次IUI和单次IUI的临床妊娠率无显著性差异(P>0.05)。对于精液质量正常、轻度少精或弱精子症和精液质量不明的患者,与单次IUI相比,双次IUI的活产率、流产率均无显著性差异(P>0.05)。结论对于轻度少精或弱精子症等男性因素不孕患者,建议进行双次IUI;而对于精液质量正常的不明原因所致的不孕,尚无充分证据支持在临床实践中常规使用双次IUI。Objective:To systematically evaluate the effect of single and double intrauterine insemination(IUI)on pregnancy outcome of infertile patients by meta-analysis.Methods:Randomized controlled trials(RCTs)about effect of single and double IUI on pregnancy outcome of infertile patients were searched in the databases of CNKI,VIP,Wanfang,PubMed,Cochrane library and Ebase from the establishment of the database to May 2022.All literatures were selected,extracted and evaluated by two evaluators according to the inclusion and exclusion criteria,and then data was analyzed by Revman 5.4 software.Results:A total of thirteen RCTs were finally included in the study.The results of meta-analysis indicated that double IUI significantly increased the clinical pregnancy rate compared with single IUI in patients with mild oligospermia or asthenospermia(P<0.0001).However,there was no significant difference in clinical pregnancy rate between double IUI and single IUI for patients with normal semen quality and unknown semen quality(P>0.05).For patients with normal semen quality,mild oligospermia or asthenospermia,and unknown semen quality,there was no significant difference in the live birth rate and abortion rate in double IUI compared with single IUI(P>0.05).Conclusions:For infertility caused by male factors such as mild oligospermia or asthenospermia,it is recommended to have double IUI.For infertility caused by unknown causes with normal semen quality,we do not support the regular use of double IUI in clinical practice.

关 键 词：宫腔内人工授精 临床妊娠率 流产率 活产率 META分析 

分 类 号：R711.6[医药卫生—妇产科学]