自然周期和促排卵周期对宫腔内人工授精结局影响

Effect of natural cycle and ovulation cycle on intrauterine artificial insemination

目的探讨自然周期与促排卵周期对宫腔内人工授精效果的影响,以期为临床中的诊疗提供参考。方法回顾性分析我院2012年10月至2017年12月在我院就诊行宫腔内人工授精患者的临床资料,根据患者人工授精时使用排卵药物患者分为观察组,未使用排卵药物患者分为对照组。分析比较两组患者妊娠率、流产率及其他并发症的发生率,比较不同方案药物干预排卵对人工授精疗效的影响。结果观察组妊娠率12.2%,对照组妊娠率8%;观察组中克罗米芬组(CC)、人绝经尿促性腺素组(HMG)、CC+HMG、来曲唑组(LE)及来LE+HMG组的临床妊娠率分别为4%、8.33%、5%、7.46%、24.37%,5组妊娠率差异具有统计学意义(P<0.05);观察组患者妊娠率高于对照组,比较差异具有统计学意义(P<0.05),两组患者流产、多胎率比较无明显统计学差异(P>0.05)。LE+HMG方案妊娠率高于其他方案,对比具有统计学差异(P<0.05),且组间流产率、多胎率及OHSS发生率的比较无明显差异(P>0.05)。结论药物促排卵可提高不孕症患者行宫腔内人工受精的妊娠率,其中来曲唑联合尿促性素方案疗效最佳。

Objective：To investigate the effect of intrauterine insemination on the effects of artificial insemination on ovulation cycle selection in order to provide reference for clinical diagnosis and treatment. Methods：The clinical data of intrauterine artificial insemination patients in our hospital from October 2012 to December 2017 were retrospectively analyzed. Patients were divided into observation group and control group according to whether ovulation cycle was artificial intervention or not.The incidence of pregnancy,miscarriage and other complications in two groups were analyzed and compared,and the effect of different programs of drug intervention on the efficacy of artificial insemination was compared. Results：The pregnancy rate in the observation group was higher than that in the control group（P〈0.05）. There was no significant difference in the incidence of miscarriage,multiple births and OHSS between the two groups（P〉0.05）.The pregnancy rate of LE ＋ HMG regimen was higher than that of other regimens（P〈0.05）. There was no significant difference in the rates of miscarriage,multiple birth rate and OHSS among the two groups（P〉0.05）. Conclusion：Drug-induced ovulation can increase the pregnancy rate of intrauterine intrauterine insemination in infertility patients without increasing complications,and the combination of letrozole and urinary cytotoxin is the best.