处理后精子数与夫精人工授精妊娠率的相关性分析

Analysis of correlation between sperm count after treatment and pregnancy rate in artificial insemination

目的探讨精液处理后前向运动精子总数(total progressive motile sperm count,TPMSC)、精子回收率对宫腔内人工授精(IUI)临床妊娠率的相关性分析。方法回顾性分析895周期IUI者的临床资料,根据精液处理后TPMSC分为<2.0×106、2.0-<5×106、5-<10×106、10-<20×106、20-<40×106、≥40×106共6组;根据精子回收率分为<20%和≥20%两组;比较各组间IUI临床妊娠率。结果人工授精共895周期,临床妊娠150周期,临床妊娠率为16.76%;处理后前向运动精子总数(TPMSC)<2.0×106共21周期,女方平均年龄32.8±5.5岁,临床妊娠率为0.00%;我们将≥2.0×106分为5组,各组间女方平均年龄、不孕年限、IUI次数、子宫内膜厚度等比较差异无统计学意义(P>0.05);各组获得的临床妊娠率分别为16.92%、13.46%、19.21%、17.75%和14.38%,各组周期临床妊娠率比较差异无统计学意义(P>0.05);根据精子回收率结果分为≥20%和<20%两组,两组间女方年龄、临床妊娠率之间比较无差异(P>0.05)。结论精子回收率的多少影响IUI临床妊娠结局意义不大;TPMSC≥2.0×106均可获得满意的临床妊娠率。

Objective To investigate the effect of total progressive motile sperm count(TPMSC)after treatment and sperm recovery on clinical pregnancy rate in intrauterine insemination(IUI).Methods Clinical data of patients with 895 cycles of IUI were retrospectively analyzed.According to the TPMSC after treatment,the patients were divided into 6 groups:<2.0 n106,2.0-<5×106,5-<10×106,10-<20×106,20-<40×106,≥40×106.The sperm recovery was divided into<20%and≥20%groups.Clinical pregnancy rates were compared between groups.Results There were 895 cycles of IUI,in which 150 cycles were clinical pregnancy,and the clinical pregnancy rate was 16.76%.There were 21 cycles which TPMSC was<2.0×106 after treatment.The average age of the patients was32.8±5.5 years,and the clinical pregnancy rate was 0.00%.Then the patients with TPMSC≥2.0×106 were divided into 5 groups.There were no statistically significant differences in the average age,infertility years,number of IUI cycles,and endometrial thickness(P>0.05).The clinical pregnancy rates of each group were 16.92%,13.46%,19.21%,17.75%and 14.38%,and the difference between groups was not statistically significant(P>0.05).According to the sperm recovery results,patients were divided into≥20%and<20%groups.There was no statistically significant difference between two groups in age and clinical pregnancy rate(P>0.05).Conclusion The amount of sperm recovery has little influence on clinical pregnancy in IUI rate.Satisfactory clinical pregnancy rates were obtained for patients with TPMSC≥2.0×106.