影响夫精宫腔内人工授精妊娠成功率相关因素分析

Related factors for influencing the success rate of intrauterine insemination with the husband's sperm

目的探讨临床因素对夫精宫腔内人工授精妊娠成功率的影响。方法 256例不孕症患者行421个周期夫精宫腔内人工授精治疗,分析年龄、不孕类型、不孕时间、治疗方式及授精时机等对夫精宫腔内人工授精妊娠成功率的影响。结果 421个人工授精周期中,48个周期获临床妊娠,临床妊娠率为11.4%;继发不孕者妊娠成功率(21.2%)高于原发不孕者(8.4%)(P<0.05),不孕时间<3 a者(17.3%)高于不孕时间3～5 a者(9.0%)和>5 a者(6.7%)(P<0.05),排卵前后双次授精者(18.3%)高于排卵前单次授精者(6.2%)和排卵后单次授精者(13.4%)(P<0.05),在不同年龄和不同治疗方式上差异无统计学意义(P>0.05);继发不孕和排卵前后双次授精是夫精宫腔内人工授精妊娠成功的影响因素(OR=2.85,95%CI:1.48～5.47,P=0.002;OR=3.31,95%CI:1.54～7.15,P=0.002)。结论不同不孕类型和接受授精的时机影响夫精宫腔内人工授精妊娠成功率,继发不孕和排卵前后双次人工授精临床妊娠成功率较高。

Objective To analyze the clinical influencing factors for the success rate of intrauterine insemination(IUI) with the husband's sperm. Methods Totally 256 patients with infertility received 421 cycles of IUI. The influences of age, type of infertility, duration of infertility, treatment method and IUI timing on the success rate of IUI were analyzed. Results Of 421 IUI cycles, pregnancy was achieved after 48 cycles, with a clinical pregnancy rate of 11.4%. The pregnancy rate was significantly higher in patients with secondary infertility(21.1%) than that in patients with primary infertility(8.4%)(P<0.05), in patients with <3-year infertility(17.3%) than that in patients with 3-to 5-year infertility(9.0%) and >5-year infertility(6.7%)(P<0.05), and in patients with double insemination(18.3%) than that in patients with single pre-ovulation insemination(6.2%) and single post-ovulation insemination(13.4%)(P<0.05). There was no significant difference in clinical pregnancy rate between patients with different ages and treatment methods(P>0.05). Secondary infertility and double insemination before and after ovulation were the influencing factors for the success rate of IUI(OR=2.85, 95%CI: 1.48-5.47, P=0.002;OR=3.31, 95%CI: 1.54-7.15, P=0.002). Conclusion Different types of infertility and timing of IUI affect the success rate of IUI. The patients with secondary infertility and double insemination before and after ovulation have high success rate of IUI.