1237例夫精宫腔内人工授精周期临床妊娠结局探讨

An analysis of clinic outcomes of 1237 intrauterine artificial insemination by husband semen cycles

目的：探讨患者年龄,不孕年限,输卵管通畅度和注入宫腔内前向运动精子总数（NMSI）对夫精宫腔内人工授精（AIH）临床妊娠率的影响,旨在更好地指导临床工作。方法：选取835对夫妻1 237个AIH周期,按年龄分为：≤35岁、36~39岁、≥40岁组;按不孕年限分为：〈2年、2~4年及〉4年;按输卵管通畅度分为：双侧输卵管通畅、单侧输卵管通畅和双侧输卵管不全通畅组;按处理后NMSI分为〈2、2~5、5~10及〉10×10^6组。结果：临床妊娠175例,周期妊娠率为14.1%,夫精宫腔内人工授精临床妊娠的成功率随着患者年龄及不孕年限的增加而降低,差异具有统计学意义（P〈0.05）;注入宫腔内前向运动精子总数（NMSI）小于5×10^6时临床妊娠率低,差异具有统计学意义（P〈0.05）;双侧及单侧输卵管通畅组妊娠率高于双侧输卵管不全通畅组。结论：年龄≥40岁,不孕年限〉4年,处理后注入宫腔内前向运动精子总数（NMSI）小于5×106或双侧输卵管不全通畅的患者,不适合继续尝试IUI治疗。

Objective： To explore the effects of female patients age, infertile duration, fallopian tube, number of motile spermatozoa inseminated （NMSI） on the clinical pregnancy outcomes of AIH treatment, to guide clinical treatment. Methods： Data of 1 237 AIH cycles of 835 couples accomplished in this Center were retrospectively studied. The cycles were grouped ac- cording to patients＇ age （≤35 years, 36-39 years, ≥40 years）, infertile duration （〈 2 years,2-4 years,〉 4years） , clearance of fallopian tube and NMSI （ 〈2,2-5,5-10 and 〉10×10^6 ） , respectively. The pregnancy rates between groups were com- pared. Results= The cycle clinical pregnancy rate was 14.1%,which decreased with the increase of the female age and infertile duration （P〈0.05）. The clinical pregnancy rate was low when number of motile spermatozoa inseminated （NMSI） was less than 5 X 106 （P（0.05）. The clinical pregnancy rate of bilateral tubal patency was higher. Conclusion： For patients aged ~40 years old, with infertile duration over 4 years, poor fallopian tube clearance or NMSI 〈5 ×10^6 total motile spermatozoa counts for insemination, were not suitable for IUI treatment.