不同正常精子形态百分率对宫腔内人工授精临床妊娠率的影响  

Effect of different percentages of normal sperm morphology on success rate of intrauterine insemination

作　　者：凌晓辉[1] 黄玉玲 陈志云[1] 刘利敏[1] 孙秋怡 柯洁荣 何妙玲 LING Xiao-hui;HUANG Yu-ling;CHEN Zhi-yun;LIU Li-min;SUN Qiu-yi;KE Jie-rong;He Miao-ling(Reproductive Medicine Centre,Huizhou Municipal Central Hospital,Huizhou 516001;Department of Gynecology,Huizhou Municipal Central Hospital,Huizhou 516001)

机构地区：[1]惠州市中心人民医院生殖中心,惠州516001 [2]惠州市中心人民医院妇科,惠州516001

出　　处：《生殖医学杂志》2023年第12期1838-1842,共5页Journal of Reproductive Medicine

基　　金：广东省医学科学技术研究基金(B2021317);惠州市科技研发计划重点项目(2022CZ010415)。

摘　　要：目的探讨不同正常精子形态百分率对宫腔内人工授精(IUI)临床妊娠率的影响。方法回顾性分析2019年12月至2022年12月于我院生殖中心进行的2637个IUI治疗周期[控制女方年龄<40岁、前向运动精子总数(TPMSC)≥500万]的患者临床资料。按照正常精子形态百分率分为3组(分别为<1.0%、≥1.0%~<4.0%及≥4.0%),比较各组间的患者临床特征及临床妊娠率;并采用Logistic回归模型来分析精子形态与IUI临床妊娠率的关系。结果纳入的2637个IUI治疗周期中,321个周期(12.17%)获得临床妊娠。在严格按照精子形态学分类分析中,正常精子形态百分率<1.0%、≥1.0%~<4.0%及≥4.0%组的临床妊娠率分别为12.87%、11.63%和12.62%,组间比较无统计学差异(P>0.05)。在多变量Logistic分析中,不同程度的精子形态不能独立预测IUI的临床妊娠结局[OR(95%CI)=1.016(0.973,1.061),P=0.470],而性功能障碍[OR(95%CI)=2.809(1.415,5.578),P=0.003]及促排卵方案[OR(95%CI)=1.480(1.058,2.072),P=0.022]可以独立预测IUI的临床妊娠结局。结论在控制女方年龄及TPMSC的前提下,不同正常精子形态百分率的患者(包括严重畸形精子症患者)的临床妊娠率并无明显差异。Objective:To investigated the effect of different sperm morphological percentages on clinical pregnancy rate in intrauterine insemination(IUI).Methods:The clinical data of 2637 IUI treatment cycles[controlling for female age<40 years old and total progressive motile sperm count(TPMSC)≥5 million]performed at our reproduction center from December 2019 to December 2022 were retrospectively analyzed.The patients were divided into 3 groups according to the percentage of normal sperm morphology(<1.0%,≥1.0%to<4.0%,and≥4.0%,respectively).The clinical characteristics and clinical pregnancy rate of patients were compared between the groups,and logistic regression models were used to analyze the relationship between sperm morphology and clinical pregnancy rate in IUI.Results:Of the 2,637 IUI treatment cycles included,clinical pregnancy was achieved in 321 cycles(12.17%).In the analysis strictly classified according to sperm morphology,the clinical pregnancy rates in the normal sperm morphology percentage<1.0%,≥1.0%to<4.0%,and≥4.0%groups were 12.87%,11.63%,and 12.62%,respectively,and there was no significant difference in the comparison of the groups(P>0.05).The multivariate logistic analysis showed that different levels of sperm morphology could not independently predict clinical pregnancy outcome in IUI[OR(95%CI)=1.016(0.973,1.061),P=0.470],whereas sexual dysfunction[OR(95%CI)=2.809(1.415,5.578),P=0.003]and ovulation induction protocol[OR(95%CI)=1.480(1.058,2.072),P=0.022]could independently predict clinical pregnancy outcome in IUI.Conclusions:Under the premise of controlling the age of the female partner and TPMSC,there was no significant difference in the clinical pregnancy rate among patients with different percentages of normal sperm morphology,including those with severe teratozoospermia.

关 键 词：男性不育症 畸形精子症 宫腔内人工授精 

分 类 号：R711.6[医药卫生—妇产科学]