供精人工授精1418个周期临床结局分析

Analysis on the clinical outcomes of artificial insemination for 1418 cycles

目的：探讨供精人工授精（AID）助孕治疗的临床结局。方法：采用回顾性研究方法，对2013年2月～2014年12月在河北省计划生育科学技术研究院生殖医学中心接受AID助孕治疗723例，共1418个周期的结局进行分析。结果：1418个AID周期中，生化妊娠率、临床妊娠率和流产率分别为33．92％、31．00％和7．52％，双胎率为0．91％。自然周期与促排卵周期的生化妊娠率、流产率和临床妊娠率比较，差异无统计学意义（P〉0．05）。在同一周期中，双次授精和单次授精的生化妊娠率比较差异无统计学意义（P〉0．05），临床妊娠率、流产率比较差异有统计学意义（P〈0．05，P〈0．01）；隔日授精流产率最高。第3个AID周期累计妊娠率达到58．37％，流产率以第4周期最高（15．38％）。第1、2、3周期生化妊娠率、临床妊娠率和流产率比较差异无统计学意义（P〉0．05）。结论：对于符合AID适应证的患者，应选择正确的AID助孕方案，对AID时机、授精次数进行恰当的把握可提高妊娠率。若行2～3个周期AID治疗未妊娠时要及时调整治疗方案。

Objective： To learn clinical outcomes of artificial insemination by donor, further to improve success rates of pregnancy. Methods 723 infertile couples with total of 1418 cycles were included in this study. All of them accepted Intra Uterine Injection by donors in the Reproductive Health Guidance Center of Hebei Family Planning Science and Technology Research Institute of during Feb.2013 and Dec.2014. Results： In the 1418 cycles of artificial insemination by donor, the rates of biochemical pregnancy, clinical pregnancy and abortion were respectively 33.92 %, 31.00% and 7.52 %. Twin pregnancy rates were 0.91%. Comparing the ovulation induction cycles with the natural cycles, the rates of biochemical pregnancy, abortion and clinical pregnancy all showed no statistically significant difference （P 〉0.05）. During the same cycle, the biochemical pregnancy rate comparing two time insemination group and a single insemination group has no statistically significant difference （P〉0.05）, but the clinical pregnancy rate between the groups was significant difference（P 〈0.05）.The abortion rates between the groups was also statistically significant difference （P 〈0.01） from the first cycle to fifth cycle, the clinical pregnancy rates showed a decreasing trend. Though in the third cycle, the cumulative pregnancy rates was 58.37%, the abortion rate in the fourth cycle was the highest（15.38%）.The rates of biochemical pregnancy, clinical pregnancy and abortion from the first cycle to the third cycle showed no statis tically significant difference（P〉0.05）. Conclusions To improve the pregnancy rates of artificial insemination by donor, eligible patients must be given the proper assisted reproduction, especially about appropriate insemination timing and insemination times. If the patient failed to be pregnant after undergoing two or three cycles, the treatment plan should be adjusted.