供精人工授精助孕结局相关影响因素

Related factors analysis of outcomes followed by artificial insemination with donor semen

目的：对男方无精子症的原因进行归纳分析，评估影响供精人工授精妊娠结局的相关因素。方法：回顾2009年1月～2012年12月在郑州大学附属医学生殖医学中心行供精人工授精（anificial insemination by donor，AID）的1435例患者共2054例周期临床资料，按患者年龄、不孕年限、不孕类型、不孕因素、助孕方案、授精时机、助孕周期数与妊娠结局的关系进行分组，分析其对AID妊娠结局的影响。结果：①年龄≥35岁组妊娠率低于〈35岁组，不孕年限≥10年组妊娠率低于〈10年组（P〈0．05）；②助孕方案中促排卵周期妊娠率低于自然周期妊娠率（P〈0．05）；③随着治疗周期数的增加，周期妊娠率下降，但累积妊娠率随之增高，以第2周期增高幅度最大，第3、4、5周期妊娠率基本平齐。结论：①不孕妇女的年龄、不孕年限、助孕方案是影响AID妊娠结局的重要因素；②对行2～3个AID周期不孕的患者可改行供精体外授精一胚胎移植助孕。

Objective： To explore the related effect factors for pregnancy outcomes of artificial insemination with donor semen by inductive analysis of male azoospermia causes. Methods ： The informations of 1 435 patients of 2 054 cycles were retrospectively analyzed, who had received AID in our reproductive medical center from 2009 January to 2012 December. According to the patientg age, duration of infertility, type of infertility, infertility factors, assisted reproduction programs, the timing of insemination, the number of assisted reproductive cycle and pregnancy outcomes, patients were divided into different groups. The related effect factors for pregnancy outcomes of artificial insemination with donor semen were analyzed. Results： ① Compared with age 〈 35 -year- old group, the pregnancy rate of woman ≥35 - years -old group was decreased; Compared with the 〈 10 years group, the pregnancy rate of the woman~ infertility duration ≥10 years group was decreased （ P 〈 0. 05） ; ②The pregnancy rate was significantly lower in the ovulation induction cycle than in the natural cycle group. （ P 〈0. 05） ; ③With the increasing of treatment cycle, the cycle pregnancy rate was decreased, but the cumulative pregnancy rate was increased. Sharpest increase was in cycle 2, pregnant rate in 3, 4, 5 cycle was equal. Conclusion：①Age, infertile years, auxiliary pregnant solution of infertile women are important effect factors of success rate of artificial insemination; ②For the cases without pregnancy after treated 2 - 3 cycles, in vitro fertilization - embryo transfer is recommended.