少、弱精子症患者精液中前向运动精子总数对宫腔内人工授精的影响

Effect of forward movement sperm number on intrauterine insemination in patients with oligospermia and asthenospermia

目的：探讨少、弱精子症患者精液处理前前向运动精子总数（TPMS）对宫腔内人工授精（IUI）妊娠率的影响。方法：回顾性分析338对因少、弱精子症来该院生殖科行夫精人工授精（AIH）的夫妇共计465个周期的临床资料。按照精液样本（a＋b）级精子总数将患者分成三组：A组（〈10×106）、B组（10×106-20×106）、C组（〉20×106）,比较这三组的前向运动精子回收率和周期临床妊娠率。结果：三组前向运动精子回收率分别为（44.88±7.56）%、（45.50±6.82）%、（42.52±10.07）%,三组比较差异无统计学意义（P〉0.05）;三组周期临床妊娠率分别为8.06%、15.72%、16.48%,A组周期妊娠率明显低于B、C两组,差异有统计学意义（P〈0.05）,B、C两组比较差异无统计学意义（P〉0.05）。结论：处理前TPMS是AIH选择和评估预后的重要参考指标。

Objective： To explore the effect of forward movement sperm number on pregnancy rate of intrauterine insemination （IUI） in patients with oligospermia and asthenospermia. Methods： The clinical data of 338 infertile couples （465 IUI cycles） receiving artificial insemination by husband （AIH） in this hospital because of oligospermia and asthenospermia were analyzed retrospectively. According to the total number of forward movement sperm of grade （ a ＋ b） , the patients were divided into group A （ 〈 10 × 10^6 ） , group B （ 10 × 10^6 - 20 × 10^6） and group C （ 〉 20× 106 ） ; the recovery rates of forward movement sperm and clinical pregnancy rates per cycle in the three groups were compared. Results ： The recovery rates of forward movement sperm in the three groups were （ 44. 88±7.56 ） %, （ 45.50 ± 6. 82） % and （ 42. 52 ± 10.07 ） % , respectively, there was no statistically significant difference among the three groups （ P 〉 0. 05 ） ; the clinical pregnancy rates per cycle in the three groups were 8. 06% , 15. 72% and 16.48% , respectively, the clinical pregnancy rate per cy- cle in group A was statistically significantly lower than those in group B and group C （ P 〈 0. 05 ）, while there was no statistically significant difference between group B and group C （ P 〉 0.05 ） . Conclusion ： Forward movement sperm number before treatment is an important in- dex to choose AIH and evaluate prognosis.