中西药及筛选精子IUI治疗免疫性不育

Treatment of Immunologic Infertility by "Er Xian Soup" with Prednisone and Intrauterine Insemination with Hus-band's Sperm.

本文采用中药二仙汤、西药强的松联合用药及筛选丈夫精子宫腔内人工授精(IUI)等方法治疗抗精子抗体(ASA)阳性引起的免疫性不育症。采用微量浅盘凝集试验(TAT)、精子制动试验(SIT)、酶联免疫吸附试验(ELISA)及混合抗球蛋白反应(MAR)等一系列ASA检测方法检测不育患者血清、精浆及宫颈粘液中的ASA。中药二仙汤有活血化瘀及行气利水之功效,辅以小剂量类固醇药物,增加免疫球蛋白的分解代谢,减少免疫球蛋白的生物合成,抑制精子抗体的形成和补体介导的精子细胞毒作用。中西药结合治疗免疫性不育症,ASA转阴率达98.1％,妊娠率为56.5％。浮游沉积法(MS)筛选精子对精液ASA阳性患者有效,ASA消失率达83.7％。MS法筛选精子IUI对宫颈粘液ASA阳性患者有效,妊娠率达33.3％。

A number of patients who have infertility show an-tisperm antibodies (ASA) in the blood serum or semen or cervical mucus, as detected by three quite different methods(tray agglutination test [TAT], sperm immobilization test[SIT] and direct mixed antiglobulin reaction [MAR] test). Fifty - four subjects received'Er Xian soup' with low dose of prednisone(5mg/d) therapy in an attempt to overcome ASA, 53 of them were negative reaction. 13 of 23 couples ( 56. 5 %) with immunologic infertility succeeded in achieving pregnancy in their partners within 3 courses of treatment. Pregnancy rate by intrauterine insemination (IUI) with selected husband's sperm in 32 subjects with seminal ASA and in 12 subjects with cervical mucus ASA was 9.3% (3/32) and 33. 3% (4/12), respectively. Our results suggest that 'Er Xian Soup' with low dose of prednisone is an effective way in treatment of immunologic infertility, and IUI significantly improves the chance of achieving a conception for existion immunlogic factor in reproductive tract.