2103个供精人工授精周期妊娠结局分析

Analysis on pregnancy outcomes of artificial insemination cycles by 2 103 donors

目的探讨供精人工授精(AID)助孕治疗的妊娠结局。方法采用回顾性分析的方法,对2010年1月-2016年6月在该所接受A1D助孕治疗的1 006对不孕夫妇,共2 103个周期的妊娠结局进行分析。结果共1 006例不孕夫妇,其中临床妊娠者578例,未妊娠者428例;临床妊娠者的年龄和不孕年限均低于非妊娠者,差异有统计学意义(t=3.205、-2.066,均P<0.05)。2 103个周期中,临床妊娠598个周期,占28.44%。自然周期和促排卵周期的临床妊娠率、流产率的差异均无统计学意义(χ~2=1.550、0.148,均P>0.05);双次授精与单次授精的临床妊娠率及流产率的差异均无统计学差异(χ~2=0.746、0.011,均P>0.05)。虽然第1、2、3、4周期临床妊娠率和流产率的差异无统计学意义(χ~2=9.022、7.967,均P>0.05),但第1周期的临床妊娠率最高且流产率最低;随着周期数的增加,临床妊娠率呈现逐渐下降的趋势,流产率呈现升高的趋势。结论女方年龄和不孕年限是影响AID妊娠率的重要因素,促排卵周期和双次授精并不能增加AID的临床妊娠率。对AID治疗4个周期仍未妊娠者,进一步寻找不孕病因,或改为供精体外受精-胚胎移植。

Objective To explore the pregnancy outcomes of artificial insemination by donor （AID） . Methods A retrospective anal- ysis was performed to analyze the pregnancy outcomes of AID for 1 006 infertile couples （2 103 cycles） in this institute from January 2010 to June 2016. Results There were 578 cases of clinical pregnancy and 428 cases of non-pregnancy among 1 006 infertile couples in this study; the age and duration of infertility among the cases of clinical pregnancy were statistically significantly lower than those of non-pregnancy （ t=3. 205, -2. 066, both P〈0. 05） . Among 2 103 cycles of AID, a total of 598 cycles were in the stage of clinical pregnancy, accounting for 28. 44%. There was no statistically significant difference in clinical pregnancy rate and abortion rate between natural cycle and ovulation cycle （X^2 = 1. 550, 0. 148, both P〉0. 05 ） . There was no statistically significant difference in clinical pregnancy rate and abortion rate between double fertilization and single insemination （X^2 = 0. 746, 0. 011, both P〉0. 05 ） . Although there was no statistically significant difference in clinical pregnancy rate and abortion rate among the first, the second, the third, and the fouth periods （X^2= 9. 022, 7. 967, both P〉 0.05 ） , clinical pregnancy rate during the first period was the highest, and abortion rate was the lowest. With the increase of the number of cycles, clinical pregnancy rate showed a downward trend, and the rate of abortion showed an upward trend. Conchlsion Maternal age and duration of infertility are important factors affecting the pregnancy rate of AID. Ovulation cycle and double fertilization can not increase the clinical pregnancy rate of AID. For the cases without pregnancy after 4 cycles, the causes of infertility should be further found, or in vitro fertilization-embryo transfer is recommended.