多囊卵巢综合征行夫精人工授精临床妊娠率的影响因素分析  

Analysis of factors affecting the clinical pregnancy rate in patients with polycystic ovary syndrome undergoing artificial insemination with husband sperm

作　　者：路鸿艳 黄雨恢 靳颖 赵秀红[1] Lu Hongyan;Huang Yuhui;Jin Ying;Zhao Xiuhong(Reproductive Medicine Center,Zibo Maternal and Child Health Hospital,Zibo Shandong 255000,P.R.China)

机构地区：[1]淄博市妇幼保健院生殖医学中心,山东淄博255000

出　　处：《中国计划生育和妇产科》2024年第12期87-93,共7页Chinese Journal of Family Planning & Gynecotokology

基　　金：山东省医药卫生发展计划项目(项目编号:2019ws301);淄博市妇幼保健领域科研创新与科技引领计划项目(项目编号:ZBFY2023001)。

摘　　要：目的探讨多囊卵巢综合征(PCOS)行夫精人工授精(AIH)患者临床妊娠率的影响因素。方法选取2019年6月至2022年12月在淄博市妇幼保健院生殖医学中心行AIH治疗的PCOS患者149例(252个周期)进行系统性回顾分析,临床妊娠62个周期,临床妊娠率24.6%。比较患者不同年龄、体质量指数(BMI)、不孕类型、优势卵泡数、hCG日子宫内膜厚度、治疗方案、治疗周期数、人工授精次数、人工授精时机、精液处理结果、不同治疗方案下妊娠结局的差异,采用Logistic回归分析临床妊娠率的影响因素。结果随着女方年龄增长、BMI降低,临床妊娠率呈逐渐下降趋势;随着hCG日子宫内膜厚度的增加,临床妊娠率有增加趋势;AIH治疗≥4个周期时,临床妊娠率下降较明显,但差异无统计学意义(P>0.05);2次AIH治疗组的临床妊娠率明显高于1次AIH治疗组(31.3%vs.17.7%,P<0.05);排卵前后各行1次AIH组的临床妊娠率显著高于排卵前单次和排卵后单次AIH组(31.3%vs.16.7%、18.6%,P<0.05)。Logistic回归分析显示人工授精时机是PCOS患者行AIH治疗临床妊娠的独立影响因素。结论人工授精次数和人工授精时机是影响PCOS患者行AIH治疗临床妊娠率的主要因素。Objective To investigate the factors affecting the clinical pregnancy rate of patients with polycystic ovary syndrome(PCOS)treated by artificial insemination with husband sperm(AIH).Methods A total of 149 PCOS patients(252 cycles)who received AIH treatment in Reproductive Medicine Center of Zibo Maternal and Child Health Hospital from June 2019 to December 2022 were selected for systematic retrospective analysis,62 cycles of clinical pregnancy,and a clinical pregnancy rate of 24.6%.The patient′s different age,body mass index(BMI),infertility type,number of dominant follicles,endometrial thickness of hCG days,treatment regimen,number of treatment cycles,number of artificial insemination,timing of artificial insemination,and semen processing results,and different treatment regimens pregnancy outcomes were compared.Logistic regression analysis was used to analyze the influencing factors of clinical pregnancy rate.Results With the increase of the woman's age and decrease of BMI,the clinical pregnancy rate showed a gradually decreasing trend;with the increase of endometrium thickness of hCG days,the clinical pregnancy rate increased;the clinical pregnancy rate decreased significantly when AIH treatment≥4 cycles,but the differences were not significant(P>0.05).The clinical pregnancy rate in the twice-AIH treatment group was significantly higher than that in the once-AIH treatment group(31.3%vs.17.7%,P<0.05).The clinical pregnancy rate of the group with one AIH before or after ovulation was significantly higher than that of the group with once-AIH before or after ovulation(31.3%vs.16.7%,18.6%,P<0.05).Logistic regression analysis showed that the timing of artificial insemination was an independent influencing factor of clinical pregnancy in PCOS patients undergoing AIH treatment.Conclusion The number and timing of artificial insemination are the main factors affecting the clinical pregnancy rate of PCOS patients undergoing AIH treatment.

关 键 词：夫精人工授精 多囊卵巢综合征 人工授精次数 人工授精时机 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学] R711.75[医药卫生—临床医学]