宫腔预处理对夫精人工授精结局的影响  

Effect of uterine cavity pretreatment on the outcome of intrauterine insemination

作　　者：庞益伟 郭晓晓 李学峰[1] 唐丽丽 王雁林[1] PANG Yiwei;GUO Xiaoxiao;LI Xuefeng;TANG Lili;WANG Yanlin(Department of Reproductive Medicine,Binzhou Medical University Hospital,Binzhou,Shandong 256603,China;Department of Endocrine,Binzhou Medical University Hospital,Binzhou,Shandong 256603,China)

机构地区：[1]滨州医学院附属医院生殖医学科,山东滨州256603 [2]滨州医学院附属医院内分泌科,山东滨州256603

出　　处：《现代医药卫生》2023年第18期3130-3134,共5页Journal of Modern Medicine & Health

摘　　要：目的探讨术前行宫腔镜检查进行宫腔预处理对夫精人工授精(IUI)妊娠结局的影响。方法回顾性分析2017年1月至2021年10月首次于滨州医学院附属医院生殖医学科行IUI助孕的1062个治疗周期的临床资料。选取其中女方双侧输卵管均通畅的964个周期纳入研究,按术前是否行宫腔镜检查分为观察组和对照组。观察组包括IUI术前行宫腔镜检查进行宫腔预处理的616个周期;对照组包括IUI术前未行宫腔镜检查的348个周期。分析两组患者的临床特征和助孕结局。结果两组在年龄、不孕年限、基础促卵泡激素(bFSH)、基础黄体生成素(bLH)、抗穆勒氏管激素(AMH)、体重指数(BMI)、处理后前向运动精子总数、手术日内膜厚度、不孕类型占比、促排卵周期占比等方面的临床特征比较,差异均无统计学意义(P>0.05)。观察组临床妊娠率、异位妊娠率、活产率均高于对照组,差异均无统计学意义(P>0.05)。观察组流产率明显低于对照组,差异有统计学意义(P<0.05)。结论双侧输卵管通畅的不孕症患者,IUI术前行宫腔镜检查进行宫腔预处理能够显著降低流产率,对提高活产率有积极的作用。Objective To investigate the effect of intrauterine pretreatment with hysteroscopy before operation on the pregnancy outcome of intrauterine insemination(IUI).Methods The clinical data of 1062 treatment cycles of IUI assisted pregnancy for the first time in the Department of Reproductive Medicine of the Affiliated Hospital of Binzhou Medical University from January 2017 to October 2021 were retrospectively analyzed.A total of 964 cycles in which the female′s bilateral fallopian tubes were unobstructed were included in the study.The patients were divided into the observation group and the control group according to whether hysteroscopy was performed before operation.The observation group included 616 cycles of uterine cavity pretreatment by hysteroscopy before IUI,and the control group included 348 cycles without hysteroscopy before IUI operation.The clinical characteristics and pregnancy outcomes of the two groups were analyzed.Results There were no significant differences between the two groups in age,duration of infertility,basal follicle stimulating hormone(bFSH),basal luteinizing hormone(bLH),anti-mullerian hormone(AMH),body mass index(BMI),total number of forward motile sperm after treatment,endometrial thickness on the day of operation,proportion of infertility type and proportion of ovulation induction cycle(P>0.05).The clinical pregnancy rate,ectopic pregnancy rate and live birth rate in the observation group were higher than those in the control group,with no statistically significant differences(P>0.05).The abortion rate in the observation group was significantly lower than that in the control group,with statistically significant differences(P<0.05).Conclusion For infertility patients with unobstructed bilateral fallopian tubes,pretreatment of uterine cavity by hysteroscopy before IUI can significantly reduce the abortion rate and have a positive effect on improving the live birth rate.

关 键 词：夫精人工授精 宫腔镜检查 输卵管通畅 流产率 活产率 

分 类 号：R715.2[医药卫生—妇产科学] R711.6[医药卫生—临床医学]