影响供精人工授精成功率因素及最佳治疗方案探讨  

Study on the factors effecting success rate of artificial insemination by donor and the treatment protocol investigation

作　　者：赵军招[1] 周玮[1] 黄学锋[1] 林金菊[1] 叶碧绿[1] 林文琴[1] 陈亦红[1] 

机构地区：[1]温州医学院附属第一医院生殖医学中心,温州325000

出　　处：《中国男科学杂志》2003年第2期113-115,共3页Chinese Journal of Andrology

摘　　要：目的　探讨影响供精人工授精 (AID)成功率的因素及其最佳治疗方案。方法　 98对夫妇行 131个AID周期 ,其中 8例行AID联合促排卵治疗 3个周期以上未孕 ,遂改为ICSI。结果　AID共 2 0例妊娠 ,且均发生在第 1～ 3个周期 ,周期妊娠率为 15 .3%。女性患者年龄大于 35岁和不孕年限大于 10年的妊娠率显著降低。精子活动率在处理前妊娠组和非妊娠组相似 ,而处理后妊娠组显著高于非妊娠组 (0 .0 2 <P <0 .0 5 )。每周期定时授精 1次与 2次的妊娠率无显著差异 (P >0 .0 5 )。 8对夫妇行 10个供精ICSI周期 ,有 5例妊娠 ,周期妊娠率为 5 0 .0 %。结论　①无精子症患者的治疗首选供精AID ;②AID的妊娠率随女性患者年龄的增长和不孕年限的延长而下降 ;③增加授精频率并不提高妊娠率 ;④当AID联合促性腺激素 3个以上周期未孕时 ,ICSI将是最佳选择。Objective To study the factors effecting success rate of AID and to explore the best treatment protocol.Methods A total of 98 infertile couples with azoospermia enlisted for AID and finished 131 cycles.Eight patients who had experienced more than three times AID in combination with hMG were failed to pregnancy,then changed to ICSI.Results Twenty pregnancies gained in 131 AID cycles,the pregnancy rate per cycle was 14.5%.The women who older than 35 and the infertility duration longer than 10 years had lower pregnancy rate,which were 5.0% and 4.3% respectively.The percentage of sperm motility were distinctly improved after Percoll gradient centrifugation,and were statistically different between pregnacy group and non pregnancy group (0.02< P <0.05).Eight couples who had undergone 10 ICSI cycles with donor semen acquired 5 pregnancies,the pregnancy rate per cycle was 50%.Conclusions AID is very effetive method for the treatment of azoospermia.It may be improved in case of combined with hMG.If it fails to conceive when experinced more than three times AID with hMG,ICSI is the best way.

关 键 词：供精人工授精 无精子症 单精子卵胞浆内注射术 妊娠 不孕 无精子症 

分 类 号：R711.6[医药卫生—妇产科学] R321[医药卫生—临床医学]