男性禁欲天数对夫精宫腔内人工授精临床结局的影响  

Effect of abstinence days on clinical outcome of intrauterine artificial insemination with husband sperm

作　　者：王佳 孙亚婷 贾瑶 朱爱珍 WANG Jia;SUN Ya-ting;JIA Yao;ZHU Ai-zhen(Assisted Reproduction Center of Yuncheng Central Hospital,Yuncheng 044000)

机构地区：[1]运城市中心医院生殖医学科,运城044000

出　　处：《生殖医学杂志》2023年第7期1045-1051,共7页Journal of Reproductive Medicine

基　　金：山西省卫生健康委科研课题(2023064)。

摘　　要：目的探讨夫精宫腔内人工授精(AIH)临床结局是否受男性禁欲天数的影响,寻找AIH治疗的最佳禁欲天数。方法回顾性分析2018年1月至2022年1月在运城市中心医院生殖医学科接受AIH治疗患者的312个AIH周期的临床资料,按取精前禁欲天数分为A组(2~3 d,n=186)、B组(4~5 d,n=91)和C组(6~7 d,n=35)。比较3组的女方基础资料、男方基础资料、精液情况和AIH治疗的临床结局,主要结局指标为临床妊娠率,采用多因素Logistic回归方程校正混杂因素,分析禁欲天数对临床妊娠的影响。结果3组患者组间男女双方基础资料比较均无统计学差异(P>0.05)。3组患者组间男性精子浓度、正常精子形态率、DNA碎片指数(DFI)、处理后前向运动精子总数比较均无统计学差异(P>0.05);B组和C组精液量显著高于A组(P<0.05);C组精子活动率、前向运动精子率最低,且与另两组比较均有统计学差异(P<0.05);B组和C组的前向运动精子总数均较A组显著增加(P<0.05),而B、C两组间前向运动精子总数比较无统计学差异(P>0.05)。3组间的HCG阳性率、临床妊娠率和活产率比较有统计学差异(P<0.05),其中C组HCG阳性率、临床妊娠率和活产率均显著高于另外两组(P<0.05),A、B组间HCG阳性率、临床妊娠率和活产率比较均无统计学差异(P>0.05);3组间流产率比较无统计学差异(P>0.05)。多因素Logistic回归分析校正年龄、体质量指数(BMI)、抗苗勒管激素水平(AMH)、AIH日内膜厚度、前向运动精子总数等混杂因素后结果显示,C组的临床妊娠率较A组显著提高[OR=2.872,95%CI(1.190,6.927),P=0.019]。结论男性禁欲6~7 d取精可明显改善AIH的临床结局。Objective:To investigate whether the clinical outcome of intrauterine artificial insemination with husband’s sperm(AIH)is affected by abstinence period in men,and to find out the optimal abstinence time for AIH treatment.Methods:The clinical data of 312 patients who received AIH treatment at the Assisted Reproduction Center of Yuncheng Central Hospital from January 2018 to January 2022 were analyzed retrospectively.According to the number of days of abstinence before semen retrieval,the patients were divided into three groups according to abstinence days:group A(2-3 days,186 cycles),group B(4-5 days,91 cycles)and group C(6-7 days,35 cycles).The basic data of both men and women,semen status and clinical outcome of AIH were compared among the three groups.The main outcome index was clinical pregnancy rate.Multivariate logistic regression equation was used to correct confounding factors and analyze the effect of abstinence days on clinical pregnancy.Results:There was no significant difference in the basic data of both men and women among the three groups(P>0.05).There were no significant differences in sperm concentration,normal sperm morphologic rate,DNA fragmentation index(DFI)and total forward motile sperm after treatment among three groups(P>0.05).The semen volume of groups B and C was significantly higher than that of group A(P<0.05).The sperm motility rate and forward motility sperm rate in group C were the lowest,and the differences were significant compared with the other two groups(P<0.05).The total number of forward motile sperm in groups B and C was significantly higher than that in group A(P<0.05),but there was no significant difference between groups B and C(P>0.05).The HCG positive rate,clinical pregnancy rate and live birth rate were significantly different among the three groups(P<0.05).The HCG positive rate,clinical pregnancy rate and live birth rate in group C were significantly higher than those in groups A and B(P<0.05),but there was no significant difference between groups A and B(P>0.05).Ther

关 键 词：禁欲天数 夫精宫腔内人工授精 HCG阳性率 临床妊娠率 流产率 活产率 

分 类 号：R711.6[医药卫生—妇产科学]