2次宫腔内人工授精失败后助孕治疗方案的选择

Treatment option for infertility following failed to two cycles intrauterine insemination

目的探讨2次宫腔内人工授精(IUI)失败后助孕治疗方案的选择合理化。方法回顾性分析2001-2009年具有实施2个周期IUI失败病史病例211例,根据其后的助孕方式分为4组:药物保守治疗组、IUI组、IVF组、腹腔镜组。对比其不孕病因分布、年龄、临床妊娠率。结果腹腔镜组通过手术发现输卵管盆腔因素及子宫内膜异位症因素比例合约36.01%,其他三组该两项不孕因素合计平均为12.14%,差异有统计学意义。IUI3次周期以上的临床妊娠率仅为7.67%,较同期本中心IUI2次周期以下的临床妊娠率明显降低;IVF组临床妊娠率为35.39%,较其他三组明显偏高,差异有统计学意义。结论 IUI治疗一般不超过2次,如不能妊娠,应对不孕因素再次进行分析评价,不要盲目重复进行IUI,使其错过更有效的、更及时的助孕方式。

ObjectiveTo explore rationalization of treatment option for infertility following failed to two cycles intrauterine insemination. Methods 211 patients following failed to two cycles intrauterine insemination from 2001 to 2009 were analyzedretrospectively. The patients were divided into 4 groups according treatment option for infertility：medicament group,IUI group,IVF group,laparoscope group. The pathogeny of infertility,age,the rate of clinical pregnancy were compared among the groups. Results The patients in laparoscope group were found fallopian tube disease and endometriosis（36.01%） ,the rate was 12.14% in another three groups,there were statistical difference. The rate of clinical pregnancy following three cycles intrauterine insemination was 7.67%,it was lower than the cycles less two times intrauterine insemination. The rate of clinical pregnancy in IVF group was significantly higher than in other groups. Conclusion IUI were not suggested more than two cycles,if not succeeded,infertility factor should be analyzed,and the other method should be employed.