精子优化处理后孵育时间与夫精宫腔内人工授精临床妊娠率的相关性研究

Time interval from the end of sperm processing to artificial intrauterine in semination with husband's sperm correlates to the rate of clinical pregnancy

目的：研究精子优化处理后孵育时间对夫精宫腔内人工授精（AIH-IUI）临床妊娠率的影响。方法：相同促排卵方案的191个AIH-IUI周期,男方精液经密度梯度离心优化处理后,将孵育时间分为0~19、20~39、40~59、60~80 min 4组;根据优化处理后前向运动精子总数（TPMC）分为（0~9）×106、（10~20）×106、（21~30）×106、〉30×1064组,分析孵育时间和优化处理后TPMC与临床妊娠率的关系,并对患者年龄、不孕年限、孵育时间、优化处理后TPMC与临床妊娠率进行Logistic多因素回归分析。结果：不同孵育时间临床妊娠率分别为12.7%、18.3%、11.4%、9.1%,孵育20~39 min组显著高于其他3组（P均〈0.05）;优化处理后4组TPMC临床妊娠率分别为0%、16.7%、11.4%、8.3%,（10~20）×106组显著高于其他3组（P均〈0.05）;Logistic多因素回归结果显示,女方年龄的增加会导致临床妊娠率显著下降（OR 0.89,95%CI 0.83~0.94）,而孵育时间20~39 min（OR 2.11,95%CI 1.34~3.13）和处理后TPMC（10~20）×106（OR 2.06,95%CI 1.32~3.46）均可显著增加临床妊娠率。结论：精子优化处理后的孵育时间是AIH-IUI临床妊娠率的重要影响因素。

Objective： To investigate the influence of the time interval from the end of semen processing to artificial intrauterine in semination with husband’s sperm（ AIH-IUI） on the rate of clinical pregnancy. Methods： This study involved 191 AIH-IUI cycles with the same ovulation induction protocol. After Percoll density gradient centrifugation,we divided the sperm into four groups based on the incubation time： 0- 19,20- 39,40- 59,and 60- 80 min,and again into another four groups according to the total progressively motile sperm count（ TPMC） ：（0- 9）,（10- 20）,（21- 30）,and 〉 30 × 106. We analyzed the correlation of the clinical pregnancy rate with the time interval from the end of sperm processing to AIH-IUI and with other influencing factors,such as maternal age,infertility duration,and semen quality. Results： The rate of clinical pregnancy was significantly higher in the 20- 39 min group（18. 3%） than in the 0- 19,40- 59,and 60- 80 min groups（12. 7,11. 4 and 9. 1%）（all P 〈 0. 05）. The（10- 20） × 106 group achieved a remarkably higher pregnancy rate（16. 7%） than the（0- 9）,（21- 30）,and 〉 30 × 106groups（0,11. 4,and8. 3%）（ all P 〈 0. 05）. Logistic multivariate analysis showed that the rate of clinical pregnancy was decreased with the increased age of the women（ OR 0. 89,95% CI 0. 83- 0. 94） but significantly elevated in the 20- 39 min group（ OR 2. 11,95% CI 1. 34- 3. 13）and of（10- 20） × 106group（ OR 2. 06,95% CI 1. 32- 3. 46）. Conclusion： The time interval from the end of sperm processing to AIH-IUI is a most significant factor influencing the rate of clinical pregnancy of AIH-IUI.