少弱畸形精子优选后体外生存时间与宫腔内人工授精妊娠率的对比研究

A study of the comparison between the surviving time of the sperm cultured in vitro in patients of oligoas-thenoteratozoospermia and the pregnancy rate of in-trauterine insemination (IUI).

为比较研究少弱畸形精子优选后体外生存时间与宫腔内人工授精(IUI)妊娠率的关系。选择因男方患少弱畸形精子症致不孕者。以改良F10培养液为精子培养液,采用上泳分离法体外处理精子后,置36.5℃二氧化碳培养箱中,分别于0,9,12,24,36,48h观察其精子活率和活力,活率≥50％者为阳性,活率<50％者为阴性。结果以生存时间(SST)表示。宫腔内人工授精按常规操作进行。共治疗60例,137个周期,妊娠19例,总妊娠率为31.7％(19/60),周期妊娠率为13.8％(19/137)。其中 SST 9h阳性5例,无一例妊娠,12h阳性10例,2例妊娠(20％),24h阳性16例,4例妊娠(25％),36h阳性29例,13例妊娠(44.8％),48h精子生存试验结果显示阴性,优选后精子体外生存时间对预测IUI妊娠率有重要临床价值,即SST为36h,人工授精妊娠率明显增高。

Objective: To compare the relationship between the surviving time of the sperm cultured in vitro in oligoasthenoteratozoospermia and the pregnancy rate of IUI.Methods: Sixty patients of male factor infertility (oligoasthenoteratozoospermia) were included in this study. The sperm prepared by swin - up was divided into two parts. One was used to do IUI and the other one was used to determine the surviving time in vitro.Results: Male factor infertility was treated with IUI in 60 patients for 137 cycles. Nineteen patientsbecame pregnant with pregnancy rate (PR) of 31. 7% (19/60). Pregnancy rate per cycle was 13. 8% (19/ 137). There were 5 cases treated with IUI but no one was pregnant when the sperm surviving time (SST) was 9h; Ten cases were treated with IUI and 2 cases were pregnant with SST = 12h; Sixteen cases were treated with IUI and 4 cases were pregnant with SST= 24h; Twenty nine cases were treated with IUI and 13 cases were pregnant with SST>36h.Conclusions; The surviving time of the sperm cultured in vitro in patients of oligoasthenoteratozoospermia is of very great value in predicting the success of IUI. The pregnancy rate of IUI was significantly increased whn the SST ws longer than 36 hours.