阿司匹林辅助宫腔内夫精人工授精治疗不明原因不孕症的效果

Therapeutic Effect of Aspirin-Assisted Intrauterine Insemination on Unexplained Infertility

目的探讨低剂量阿司匹林辅助宫腔内夫精人工授精(AIH)治疗不明原因不孕症(UI)的临床效果。方法收集2015年1月至2016年12月93例因不明原因不孕行AIH的患者。根据是否服用阿司匹林将患者分为A、B组,A组(n=44)于月经第3天口服阿司匹林肠溶片50mg·d-1直至宫腔内人工授精(IUI)术后2周;B组(n=49),未服用阿司匹林。对2组人绒毛膜促性腺激素(HCG)注射日子宫内膜厚度、内膜类型及子宫动脉血流阻力指数(RI)进行分析,并比较2组的临床妊娠率。结果 2组子宫内膜厚度比较,差异无统计学意义(P>0.05);A组A型内膜所占比高于B组(95.5%比87.8%,P<0.05);A组RI低于B组[(0.75±0.11)比(0.92±0.03),P<0.05];A组临床妊娠率高于B组(18.0%比10.2%,P<0.05)。结论低剂量阿司匹林可改善子宫内膜容受性,提高不明原因不孕患者IUI的临床妊娠率。

Objective To explore the clinical effect of low dose aspirin assisted intrauterine in semination（AIH） on unexplained infertility（UI）.Methods Data of 93 patients who underwent AIH for UI from January 2015 to December 2016 were collected. These patients were given oral enteric coated aspirin tablets 50 mg/day（group A,n 44） or not（group B,n 49） from the 3rd day of menstrual period to 2 weeks after operation. Endometrial thickness, endometrial pattern and uterine artery blood flow resistance index（RI） were measured on the day of human chorionic gonadotropin injection.In addition, clinical pregnancy rate was compared between the two groups. Results There was no significant difference in endometrial thickness between the two groups （P〈0.05）.Compared with group B,aspirin treatment increased the proportion of type A endome trium（95.5% vs 87.8%,P〈0.05） and clinical pregnancy rate（18.0% vs 10.2%,P〈0.05）,but decreased the RI（（0.75±0.11） vs （0.92±0.03） ,P〈0.05）.Conclusion Low dose aspirin assisted AIH can improve endometrial receptivity and increase clinical pregnancy rate in UI patients.