三种扳机方法对宫腔内人工授精妊娠结局的影响

The effect of three trigger methodson pregnancy outcome of intrauterine insemination

目的比较3种不同扳机方法诱导排卵后行宫腔内人工授精(IUI)助孕治疗的不孕患者的妊娠结局。方法收集2016年7月至2018年6月在浙江大学医学院附属妇产科医院行第一次或第二次IUI的患者资料,按不同药物扳机诱导排卵进行分组,分为绒促性素(HCG)组154例、促性腺激素释放激素激动剂(GnRHa)组94例、HCG联合GnRHa双扳机组93例。回顾性分析3组的一般情况和IUI妊娠结局(主要指标包括临床妊娠率和28周以上持续妊娠率,次要指标包括生化妊娠率、流产率、异位妊娠率和多胎妊娠率)。结果不孕患者IUI治疗临床妊娠率和28周以上持续妊娠率在HCG组、GnRHa组、HCG联合GnRHa双扳机组分别为18.2%、24.5%、22.6%和16.9%、19.1%和18.3%(P>0.05),差异无统计学意义,次要指标在3组中差异无统计学意义(P>0.05)。结论HCG、GnRHa、HCG联合GnRHa双扳机等扳机方法均能有效地诱导排卵,对IUI妊娠结局影响接近。

Objective To analysepregnancy outcome of intrauterine insemination(IUI) after three different trigger methods. Methods A retrospective study was designed, included 341 couples seeking for their first or second IUI cycle from 2016.7 to 2018.6 in women′s hospital, school of medicine, zhejiang university. Ovulation was trigger by HCG 10 000 IU in 154 cases named HCG group, by 0.1/0.2 mg triptorelinin 94 cases called GnRHa group, by HCG combined with triptorelinin in 93 cases defined as dual trigger group. The primary outcome was clinical pregnancy rate and ongoing pregnancy rate beyond 28 gestational weeks,second outcome which contains biochemical pregnancy, miscarriagerate, ectopic pregnancy rateand multiple pregnancy rate were also observed in three groups. Results Pregnancy outcomeshowed no significant difference among three groups. Conclusions The study suggested that all this three methods(HCG trigger, GnRHa trigger, HCG combined with GnRHa dual trigger) couldinduced ovulation, their effects on IUI pregnancyout come were similar.