精液处理前液化时间对人工受精妊娠率的影响

Intervals from semen collection to sperm wash in artificial insemination by husband(artificial insemination by husband,AIH)semen influenced pregnancy outcome

目的探讨精液取出后液化10~20 min处理与液化21~30 min处理对人工受精妊娠率的影响。方法选择2011年12月—2015年12月行人工授精助孕的患者,随机分为A组、B组。A组精液处理前液化10~20 min(176 cycle),B组精液处理前液化21~30 min(360 cycle)。比较组间a+b级精子总数、妊娠率及流产率。计量资料比较采用t检验,计数资料比较采用χ~2检验,妊娠率的影响因素采用Logistic多因素回归分析,P<0.05为差异有统计学意义。结果 A组a+b级精子总数[(58.0±38.2)×10~6/ml]低于B组[(66.0±29.4)×10~6/ml]a+b级精子总数。A组妊娠率、流产率分别为21.0%(37/176)、29.7%(11/37),B组分别为16.3%(59/360)、22.0%(13/59),两组比较差异无统计学意义(均P>0.05)。男方年龄、卵泡期用药、非男方因素、处理后a+b级精子总数与妊娠率有关(OR=6.58、4.57、4.13、4.09,均P<0.05)。结论缩短精液处理前液化时间对妊娠率无明显影响。

Objective Retrospective study to determine whether AIH pregnancy in intervals from collection to sperm wash （collection to sperm wash,C-SW）10-20 min was higher than C-SW 21-30 min.Methods A retrospective analysis was performed in infertile patients undergone AIH in our center from December 2011 to December 2015. The patients were randomly divided into group A and B.The group A were 10-20 rain. from collection to sperm Wash（176 cycle） and the group B were 21-30 min. from collection to sperm wash（360 cycle）. The sperms of grade a, b were compared,and rate of pregnancy and abortion were compared between the two groups too. Measurement data uses t test,and count data uses Z2 test, the influence of pregnancy rate uses factor analysis Logistic multifactor regression,P〈0.05 is considered statistically significant. Result The number of sperms of grade a, b were[（58.0 ± 38.2）×10^6/ml vs.（66.0 ± 29.4）×10^6/ml）] in group A and B. Pregnancy rate per cycle were 21.0% and abortion rate per cycle was 29.7% in 10-20 min. from collection to sperm wash group.Pregnancy rate per cycle were 16.3% and abortion rate per cycle was 22.0% in 21-30 min. from collection to sperm wash group, these findings were not statistically significant （P〉0.05）. Male age, follicle stimulating, beside male factor infertility,the number of washed sperms of grade a and b related to rate of pregnancy （OR=4.08,4.57,4.13,4.09, All P〈0.05）. Conclusions Shorter time from Collection to sperm wash were not related to rate of pregnancy.