洗涤后前向运动精子总数少的宫腔内人工授精周期病例的妊娠结局分析

Pregnancy Outcomes of Women with Low Number of Total Progressively Motile Sperm Post Wash in Intrauterine Insemination Cycles

【目的】研究宫腔内人工授精（IUI）中洗精后前向运动精子数目少的病人行IUI获得妊娠的机会,以及其前向运动精子总数与妊娠率的关系。【方法】回顾性分析中山大学附属第一医院于2012-2014期间的IUI治疗周期。根据洗涤后的前向运动精子总数（TPMSC）,将TPMSC〈10.0×106的周期纳入研究,分析其妊娠结局;为进一步分析此部分病人中影响其妊娠率的因素,尤其是TPMSC（106）与妊娠率的关系,将病人分为四组：0.1~〈0.5,0.5~〈1.0,1.0~〈5.0,5.0~〈10.0,比较各组间的妊娠结局。【结果】TPMSC〈10.0×106的IUI周期共1 056例,周期妊娠率为12.3%,流产率为16.2%,活婴出生率为83.9%。洗精后TPMSC〈0.1×106的患者均未获得妊娠,在0.1×106≤TPMSC〈10.0×106范围内,各组的周期妊娠率分别为14.4%、10.6%、12.5%和12.0%,组间妊娠率差异无统计学意义,经Logistic回归分析显示,在0.1×106≤TPMSC〈10.0×106的病人中,IUI的妊娠率受女方年龄、不孕因素与不孕年限的影响,TPMSC不影响IUI的妊娠率。【结论】精液离心洗涤后前向运动精子总数少的病人,在一定的TPMSC范围内（〉0.1×106）,通过IUI治疗可以获得较满意的妊娠率,TPMSC与妊娠率无相关性。

【Objective】 To investigate the pregnancy outcomes of patients who have low number of total progressively motile sperm count（TPMSC） post wash in intrauterine insemination（IUI） cycles. 【Methods】 1056 IUI cycles with TPMSC 10.0 ×106were included and their pregnancy outcomes were retrospectively analyzed. To further study the relationship between TPMSC and pregnancy rate, cycles with low number of TPMSC（× 106） were divided into four groups; 0.1 ~ 0.5, 0.5 ~ 1.0,1.0 ~ 5.0,5.0 ~ 10.0,the pregnancy rates were compared among these groups. 【Results】 1 056 IUI cycles with TPMSC 10.0 × 106 were included in the present study got an overall pregnancy rate of 12.3%, the miscarriage rate was 16.2% and the live birth rates was 83.9%.The patients who have post washed TPMSC 0.1 × 106 failed to obtain a pregnancy. For patients with low number of TPMSC post wash（0.1 × 106≤TPMSC 10.0 × 106）, the pregnancy rates per cycle were 14.4%,10.6%,12.5%, and 12.0%, respectively in four groups with no statistical difference. After Logistic regression analysis, the pregnancy rates of patients with low number of TPMSC post wash were influenced by female ages, infertility factors and duration time of infertility. TPMSC post wash was not related with pregnancy rates.【Conclusions】 Patients with low number of total progressively motile sperm count post wash（0.1 × 106≤ TPMSC 10.0 × 106） can still get satisfactory rates of pregnancy through IUI treatment, but TPMSC and pregnancy rate were not correlated within this TPMSC range.