男性射精障碍行宫腔内人工授精的临床研究

Clinical analysis of the intrauterine insemination outcome of infertility couples with male ejaculation disorders

目的：探讨对男性射精障碍所致不育夫妻进行宫腔内人工授精（Intrauterine insemination， IUI）的临床疗效。方法：对14例男性射精障碍所致不育夫妻进行宫腔内人工授精的临床资料进行回顾性分析，其中2例为逆行射精，12例为不射精。逆行射精者，取精前常规口服碳酸氢钠碱化尿液，排尿后手淫取精，收集标本；对于不射精者，常规手淫取精收集标本。采用密度梯度离心法处理精液，随后进行IUI。根据IUI精液处理后精子前向运动总数（Processed total motile sperm count，PTMS），将IUI周期分为三组：PTMS＜10×10^6（A组）、PTMS＜10×10^6～20×10^6（B组）和PTMS≥20×10^6（C组），统计每组的妊娠率，并对妊娠周期与非妊娠周期处理后注入宫腔内精液参数进行统计学分析。结果：14例男性射精障碍的不育夫妻经30个周期IUI治疗，10例女方怀孕，临床周期妊娠率为33．33％，临床累积妊娠率为71．43％。PTMS＜10×10^6（A组）、10×10^6～20×10^6（B 组）和≥20×106（C 组），这三组周期妊娠率分别25．00％、40．00％和33.33％。妊娠周期与非妊娠周期处理后注入宫腔内精液参数均无统计学差异（P均＞0.05）。结论：对男性射精障碍所致不孕夫妻进行IUI治疗，效果明显、临床实用性强。

Objectives：To investigate the Intrauterine insemination,IUI clinical outcome of infertility couples with male ejaculation disorders.Methods：The clinical data of 14 male infertility couples with ejaculation disorders,who received intrauterine insemination,was analyzed retrospectively,including 2 cases of retrograde ejaculation and 12 cases of anejaculation.For patients with retrograde ejaculation,before sperm retrieval,they took the sodium bicarbonate alka-line urine orally.After urination masturbation,the sperm was collected;for patients with anejaculation,masturbation was used for sperm collection.IUI was conducted after density gradient centrifugation of the sperm.According to the pro-cessed total motile sperm count,the IUI cycle was divided into three groups：PTMS〈10 ×10^6 （group A）,〈10 ×10^6 -20 ×10^6 （group B）and ≥20 ×10^6 （group C）,the pregnancy rate of each group was calculate and the intrauterine semen parameters between pregnant cycle and non-pregnant cycle were statistically analyzed.Results：After 30 cycles of IUI therapy,in 14 couples with male ejaculation obstacle infertility,10 cases got pregnancy;clinical cycle pregnancy rate was 33.33%,and clinical cumulative pregnancy rate was 71.43%.Conclusion：The treatment of IUI for infertile couples caused by male ejaculation disorders is obviously effective with clinical practicability.