自然周期和促排卵周期宫腔内人工授精临床结局的比较

Comparison of Pregnancy Outcomes between Natural Cycle and Hyperstimulation Cycle in Intrauterine Insemination

目的:分析3777个夫精宫腔内人工授精周期,探讨促排卵周期的安全性。方法:总结我院2006年1月至2008年12月706个自然周期和3071个促排卵周期,比较两组妊娠结局。结果:①自然周期与促排卵周期妊娠率比较,差异无统计学意义(P>0.05);但促排卵周期流产率较高(P<0.05);②促排卵周期中仅氯米芬+雌二醇+HMG方案妊娠率高于自然周期(P<0.05),仅氯米芬+雌二醇方案流产率高于自然周期(P<0.05);③不明原因不孕患者促排卵周期流产率高于自然周期(P<0.05);④非排卵障碍患者,促排卵周期与自然周期妊娠率、流产率和异位妊娠率间比较,差异无统计学意义(P>0.05);⑤促排卵周期中排卵障碍患者妊娠率和双胎率均高于其他病因患者(P<0.05)。结论:促排卵周期与自然周期相比流产率增高;促排卵周期可以提高排卵障碍患者的妊娠率但不能改善非排卵障碍患者的妊娠结局;自然周期宫腔内人工授精安全性较高。

Objective ：To study the safety of hyperstimulation cycle in intrauterine insemination （IUI） with husband sperm by analyzing 3777 cases in our department. Methods： The pregnancy outcomes of 706 nature cycles and 3071 hyperstimulation cycles from Jan 2006 to Dec 2008 in our hospital were analyzed. Results：There was no statistic significance in pregnancy rate between natural cycles and hyperstimulation cycles（P〉 0. 05）. The abortion rate was higher in hyperstimulation group than that in natural group （P 〈 0.05 ）. The pregnancy rate of combination clomiphene with estradiol and HMG was higher in hyperstimulation group than that in natural group （ P 〈 0.05）, but the abortion rate of combination clomiphene with estradiol was also higher（ P〈 0. 05）. The abortion rate of unknown infertility patients was higher in hyperstimulation group than that in natural group（ P 〈 0.05）. There were no statistic significance between hyperstimulation group and natural group in pregnancy rate, abortion rate and ectopic rate in ovulation （P〉0. 05）. In hyperstimulation cycles, pregnancy and twins rates of anovulation were significantly higher than other disorders（ P 〈 0.05）. Conclusions：There is higher abortion rate in hyperstimulation cycles than natural cycles. Hyperstimulation can improve the pregnancy rate in anovulation except ovulation. There is high safety of IUI in natural cycle.