自然周期与促排卵周期宫腔内人工授精助孕临床结局分析

Clinical outcome analysis of intrauterine insemination in natural cycle or ovulation induction cycle in normal ovulation patients

目的研究无排卵障碍不孕症患者自然周期与促排卵周期宫腔内人工授精(IUI)临床结局,探讨促排卵IUI治疗的有效性及安全性。方法回顾性分析我中心2012年1月至2014年4月无排卵障碍不孕症患者行IUI治疗的600个周期,其中自然周期355例,促排卵周期245例,比较两组患者临床结局。结果 1促排卵周期患者的临床妊娠(14.69%)显著高于自然周期患者的临床妊娠率(8.45%),差异有统计学意义(P<0.05)。2促排卵周期流产率为27.78%,略高于自然周期的10.00%,但差异无统计学意义(P>0.05)。3促排卵周期活产率为11.02%,略高于自然周期的7.60%,但无统计学差异(P<0.05),且所有新生儿均未发现任何出生缺陷。4按年龄段分组:年龄≤35岁患者促排卵周期的临床妊娠率为15.94%,显著高于同年龄段患者自然周期的9.09%(P<0.05);而年龄>35岁患者促排卵周期与自然周期的临床妊娠率分别为7.89%和5.79%,无统计学差异(P>0.05)。结论促排卵治疗能显著提高无排卵障碍不孕症患者IUI临床妊娠率,但对于年龄>35岁患者,促排卵治疗并不能改善IUI临床妊娠率。

Objective：To compare the clinical outcome of intrauterine insemination（IUI）between natural cycle and ovulation induction cycle in normal ovulation patients,and explore the effect and safety of stimulated IUI.Methods：The data of 600 IUI cycles in normal ovulation patients in the IVF center from January 2012 to April 2014 were analyzed retrospectively.There were 355 natural IUI cycles and 245 ovulation induction IUI cycles.The clinical outcomes were compared between the two groups.Results：The clinical pregnancy rate was significantly higher in ovulation induction cycle than that in the natural cycle（14.69% vs.8.45%）（P〈0.05）.The miscarry rate（27.78% vs.10.00%）and the live birth rate（11.02% vs.7.60%）in the ovulation induction cycle were not significantly different with the natural cycle（P〉0.05）.No birth defect was found in the two groups.In the sub group of patients less or equal to 35 years old,the clinical pregnancy rate was significantly higher in the ovulation induction cycle than that in the natural cycle（15.94% vs.9.09%）（P〈0.05）.For patients over 35 years old,the clinical pregnancy rate was comparable between the two groups（7.89% vs.5.79%）（P〉0.05）.Conclusions：The ovulation induction IUI could increase clinical pregnancy rate compared with natural cycle in normal ovulation patients,but the effect was not significant for the patients more than 35 years old.