供精人工授精中卵泡直径对妊娠率的影响

Effect of follicle diameter on pregnancy rate in artificial insemination by donor

目的研究卵泡直径对供精人工授精(AID)妊娠率的影响。方法收集2016年1月至2018年12月在我生殖中心行AID助孕治疗的1073例不孕夫妇共2333个治疗周期的数据,根据术前卵泡直径将患者分为A组(<17 mm)、B组(17~<19 mm)、C组(19~<21 mm)、D组(≥21 mm),分析四组的妊娠情况。结果临床妊娠共636例,其中双胎共8例(1.26%),流产46例(7.23%),宫外孕10例(1.57%)。A、B、C、D组的临床周期妊娠率分别为27.48%、28.20%、26.98%、21.26%,B组高于其他三组。Logistic回归分析结果显示,女方年龄、卵泡直径对临床妊娠结果有一定的影响(P<0.05)。结论通过对不同卵泡直径AID妊娠结局的分析,发现卵泡直径15~17 mm者不宜放弃人工授精手术,但对于卵泡发育不良未妊娠者,再次AID可采用促排卵方案,以改善卵子质量,提高临床妊娠率。

Objective To study the effect of follicle diameter on pregnancy rate in artificial insemination by donor(AID).Methods The data of 2333 treatment cycles of 1073 infertile couples who received AID pregnancy treatment in our reproductive center from January 2016 to December 2018 were collected.According to the preoperative follicle diameter,the patients were divided into group A(<17 mm),group B(17-<19 mm),group C(19-<12 mm)and group D(≥21 mm)and D,and the pregnancy situation of the four groups was analyzed.Results There were 636 cases of clinical pregnancy,including 8 cases of twins(1.26%),46 cases of abortion(7.23%),and 10 cases of ectopic pregnancy(1.57%).The clinical cycle pregnancy rate of group A,B,C and D were 27.48%,28.20%,26.98%and 21.26%respectively;the clinical cycle pregnancy rate of the group B was higher than that of the other three groups.Logistic regression analysis showed that the age of the woman and follicle diameter had a certain impact on the clinical pregnancy results(P<0.05).Conclusion Through the analysis of pregnancy outcomes of AID with different follicle diameters,it was found that artificial insemination should not be given up for those with follicle diameter of 15-17 mm.However,for patients with follicular dysplasia who are not pregnant,ovulation induction program can be used for AID again,so as to improve the quality of ova and the clinical pregnancy rate.