单中心287周期夫精宫腔内人工授精临床结果分析  

Analysis of clinical outcomes of 287 cycles of intrauterine artificial insemination with husband sperm in a single center

作　　者：赵静[1] 苏果[1] 王含必 张静[1] ZHAO Jing;SU Guo;WANG Han-bi;ZHANG Jing(Department of Reproductive Medicine,Fuyang People’s Hospital,Fuyang 236000;Department of Obstetrics&Gynecology,Peking Union Medical College Hospital,Peking Union Medical College&Chinese Academy of Medical Sciences,National Clinical Research Center for Obstetric&Gynecologic Diseases,National Key Laboratory for Difficult&Severe Diseases&Rare Diseases,Beijing 100730)

机构地区：[1]阜阳市人民医院生殖医学科,阜阳236000 [2]中国医学科学院、北京协和医学院、北京协和医院妇产科,国家妇产疾病临床医学研究中心,疑难重症及罕见病国家重点实验室,北京100730

出　　处：《生殖医学杂志》2023年第7期1030-1037,共8页Journal of Reproductive Medicine

摘　　要：目的探讨宫腔内人工授精(IUI)临床妊娠率的影响因素。方法回顾性分析自2019年1月至2022年7月在阜阳市人民医院生殖中心采用IUI助孕的287个周期不育夫妇的临床资料。分析女方年龄、女方体质量指数(BMI)、不育类型/年限、不育因素、首次IUI时子宫内膜厚度(EMT)、卵泡发育方式、IUI时机、卵泡发育时间、IUI时成熟卵泡数目等对临床妊娠率的影响。结果共纳入287个IUI周期,其中55个周期获临床妊娠,临床妊娠率为19.16%。单因素分析结果显示:继发不育患者临床妊娠率显著高于原发不育患者(25.49%vs.15.68%,P<0.05);不育年限≤5年者临床妊娠率显著高于不育年限>5年者(20.45%vs.0%,P<0.05);经手术确诊合并Ⅰ~Ⅱ期子宫内膜异位症者临床妊娠率显著低于未被证实合并该症者(9.09%vs.21.55%,P<0.05);首次IUI时EMT>10 mm者临床妊娠率显著高于EMT<8 mm及EMT 8~10 mm者(23.91%vs.7.02%、21.74%,P<0.05);卵泡发育天数>12 d者临床妊娠率显著高于卵泡发育天数≤12 d者(22.96%vs.10.99%,P<0.05);在其他不育原因分组以及卵泡发育方式、授精次数、子宫内膜形态、成熟卵泡个数等方面分组比较,临床妊娠率均无统计学差异(P>0.05)。多因素分析表明:原发不育[OR=2.025,95%CI(1.096,3.743)]、合并Ⅰ~Ⅱ期子宫内膜异位症[OR=0.366,95%CI(0.137,0.979)]是IUI临床妊娠率的独立影响因素(P<0.05)。结论原发不育、合并Ⅰ~Ⅱ期子宫内膜异位症是IUI临床妊娠率的独立影响因素。不育年限≤5年、首次IUI时子宫内膜厚度>10 mm、卵泡发育天数>12 d时IUI临床妊娠率相对较高,而增加每周期授精次数不能提高IUI周期临床妊娠率。Objective:To investigate the factors influencing the clinical pregnancy outcomes of intrauterine artificial insemination(IUI)with husband sperm.Methods:The clinical data of 287 IUI cycles at the Reproductive Center of Fuyang People’s Hospital from January 2019 to July 2022 were retrospectively analyzed.The effects of female age,female body mass index(BMI),infertility type/years,infertility factors,endometrial thickness(EMT)at first IUI,follicle development pattern,IUI timing,follicle development time,and the number of mature follicles at IUI on the clinical pregnancy rate were analyzed.Results:A total of 287 IUI cycles were included,of which 55 were clinically pregnant,with a clinical pregnancy rate of 19.16%.Univariate analysis showed that the clinical pregnancy rate of the patients with secondary infertility was significantly higher than that of the patients with primary infertility(25.49%vs.15.68%,P<0.05).The clinical pregnancy rate of the patients with infertility years≤5 years was significantly higher than that of the patients with infertility years>5 years(20.45%vs.0%,P<0.05).The clinical pregnancy rate of the patients with stage Ⅰ-Ⅱ endometriosis confirmed by operation was significantly lower than that of the patients without endometriosis(9.09%vs.21.55%,P<0.05).The clinical pregnancy rate of the patients with EMT>10 mm at the first IUI was significantly higher than that of patients with EMT<8 mm or EMT 8-10 mm(23.91%vs.7.02%,21.74%,P<0.05).The clinical pregnancy rate of the patients with follicular development days>12 days was significantly higher than that of patients with follicular development days≤12 days(22.96%vs.10.99%,P<0.05).There were no significant differences in the clinical pregnancy rate among the groups with other infertility causes,follicle development pattern,insemination frequency,endometrial morphology,and number of mature follicles(P>0.05).Multivariate analysis showed that primary infertility[OR=2.025,95%CI(1.096,3.743)]and stage Ⅰ-Ⅱ endometriosis[OR=0.366,95%CI(0.137,0.97

关 键 词：宫腔内人工授精 临床妊娠率 影响因素 

分 类 号：R711.6[医药卫生—妇产科学]