夫精人工授精过程中的精液质量评估

Evaluating the sperm quality of husband during intrauterine insemination

目的：分析精液中处理前前向运动精子总数（TPMSc）与处理后前向运动精子总数fPTMSC）的相关性。方法：收集426对不孕夫妇共563个IUI周期的临床资料，统计分析TPMSC与正常形态精子百分率、精子浓度、活力、PTMSC的相关性，按照TPMSC不同分成3个区间组：〈10×10^6组（A组）、（10—19）×10^6组（B组）、≥20×106^组（C组），比较这3组的前向运动精子（PMS）回收率和周期临床妊娠率。结果：TPMSC与正常形态精子百分率、精子浓度、活力、PTMSC有显著相关性（P〈0．001）；不同TPMSC数量组处理后PMS回收率无统计学差异（P〉0．05）：周期临床妊娠率分别为6．82％、17．59％、16．35％，A组周期妊娠率明显低于B组、c组（P〈0．05），B、c组间差异无统计学意义（P〉0．05）。结论：TPMSC是反映精液质量的重要综合参数，是夫精人工授精选择和评估预后的重要参考指标。

Objective： To explore the relationship between the total progressive motile sperm count （TPMSC） and the processed total motile sperm count （PTMSC）. Methods： The clinical data of 426 infertile couples who underwent 563 IUI cycles were collected. The relevance among TPMSC, the percentage of sperm normal form, sperm concertration, motility and PTMSC was analyzed. According to TPMSC, the patients were divided into 3 groups： 〈10 × 10^6 （group A）, （10-19）× 10^6 （group B）, and ≥ 20 × 10^6 （group C）. The difference of the recovery rates of progressive motile sperm （PMS） and pregnancy rate per cycle among the subgroups was then compared by statistical analysis. Results： TPMSC was significantly correlated with the percentage of sperm normal forms, sperm concertration, motility and PTMSC （P〈0.001）. There was no statistically significant difference in recovery rates of PMS among the three groups （P〉0.05）. The pregnancy rates of groups A, B and C were 6.82%, 17.59% and 16.35%, respectively, the pregnancy rate per cycle in group A was significantly lower than that in groups B and C （P〈0.05）, but no significant difference was found between group B and group C （P〉0.05）. Conclusion： TPMSC is an important comprehensive parameter. It is an important reference to choose cases for IUI and to assess pregnancy rates of IUI.