1382周期宫腔内夫精人工授精临床因素分析

Analysis on clinical factors related to artificial insemination with husband sperm in 1382 cycles

目的:对宫腔内夫精人工授精患者的临床资料进行分析,评估相关因素对夫精人工授精妊娠率的影响。方法:选择2007年1月～2009年3月因不孕于同济医院生殖医学中心进行宫腔内人工授精(IUI)治疗的夫妇943对,共1 382个周期。分析女性年龄、不孕年限、不孕原因、IUI治疗周期数及促排卵方案等临床因素和妊娠率之间的关系。结果:①年龄超过40岁妊娠率明显下降(P<0.05);不孕年限超过10年的妊娠率明显下降(P<0.05)。②继发性不孕的妊娠率高于原发性不孕的妊娠率(P<0.05)。③女方因素中,妊娠率最高的是多囊卵巢综合征,最低的是子宫内膜异位症;男方因素中,以性功能障碍和精液液化不良的妊娠率最高,畸精症的妊娠数为0。④促排卵周期的妊娠率高于自然周期,但差异无统计学意义。结论:在夫精人工授精中,患者年龄、不孕年限、不孕类型、不孕原因和促排方案均可影响妊娠率,治疗时应综合考虑多种因素的影响。

Objective：To analyze the clinical data of patients receiving intrauterine insemination with husband sperm,evaluate the effect of relative factors on pregnancy rate after intrauterine insemination. Methods：943 infertile couples who received intrauterine insemination in the hospital from January 2007 to March 2009 were selected,1 382 cycles were included.The relationship between clinical factors including maternal age,infertile time,infertile causes,cycles of intrauterine insemination,ovulation induction protocol and pregnancy rate was analyzed. Results：The pregnancy rate of the patients more than 40 years decreased significantly（P〈0.05）.The pregnancy rate of the patients with infertile time〉10 years decreased significantly（P〈0.05）.The pregnancy rate of the patients with secondary infertility was significantly higher than that of the patients with primary infertility（P〈0.05）.Among female factors,the pregnancy rate of the patients with polycystic ovary syndrome was the highest,the pregnancy rate of the patients with endometriosis was the lowest;among male factors,the pregnancy rate of the patients with sexual dysfunction and poor semen liquefaction was the highest,the pregnancy rate of the patients with teratozoospermia was 0.The pregnancy rate of ovulation induction cycles was higher than that of nature cycles,but there was no significant difference. Conclusion：In the course of intrauterine insemination with husband sperm,age,infertile time,infertile types,infertile causes and ovulation induction protocol can affect pregnancy rate,the effects of various factors should be considered comprehensively in the process of therapy