胰激肽原酶治疗对夫精宫腔内人工授精反复失败患者IVF-ET助孕结果的影响

Effects of pancreatic kininogenase in vitro fertilization-embryo transfer on in the women with recurrent failure of intrauterine insemination by husband before

目的:探讨胰激肽原酶治疗对夫精宫腔内人工授精反复失败患者体外受精-胚胎移植(IVF-ET)助孕结果的影响。方法:选取本院2016年1月-2020年12月因男性因素夫精宫腔内人工授精反复失败的192例患者作为研究对象,按照随机数字表法分为对照组和观察组各96例。对照组给予维生素E治疗,观察组给予胰激肽原酶治疗,两组连续治疗3个月后行IVF-ET。比较两组治疗前后精子质量、患者配偶的促排卵相关指标、胚胎体外发育情况以及妊娠结局。结果:治疗后两组精液量、精子浓度均升高,但两组比较无差异(P>0.05);两组前向运动精子率、正常形态精子率均升高,且观察组高于对照组(P<0.05);DFI降低且观察组低于对照组(P<0.05)。两组患者配偶的Gn使用时间及用量、hCG日子宫内膜厚度及雌二醇水平,以及获卵数、MⅡ卵数均无差异(P>0.05)。观察组受精率、2PN率、卵裂率、优胚率、囊胚形成率均高于对照组(P<0.05)。两组流产率无差异(P>0.05);观察组新鲜移植和冷冻移植的临床妊娠率(90.9%、75.7%)、总累积活产/继续妊娠(74.0%)均高于对照组(46.2%、58.6%、45.8%)(均P<0.05)。结论:反复夫精宫腔内人工授精失败患者进行IVF-ET前给予胰激肽原酶治疗,能够提高临床妊娠率,且治疗时间短、成本低,有临床推广价值。

Objective:To explore the ffects of pancreatie kininogenase for treating the women with recurrent failure ofintrauterine insemination by husband before in vitro fertilization-embryo transfer(IVF-ET)on their pregnancy out-comes.Methods:A total of 192 women with repeated failure of intrauterine insemination by husband were selected and were divided into two groups(96 cases in each group)according to the random number table method from January 2016 to December 2020.The women in the control group were given witamin E treatment for 3 months,and the women in the observation group were given pancreatic kininogenase treatment for 3 months.Then the women in both groups had been IVF-ET.The sperm quality of the spouses before and after treatment,the ovulation induction-related indica-tors,the development situation of the in vitro embryo,and the pregnancy outcomes of the women were compared be-tween the two groups.Results:The semen volume and sperm concentration of the spouses of the women in the two groups after treatment had increased significantly,but which had no significant difference of the women between the two groups(P>0.05).The rates of the forward motility sperm and the normal morphologic sperm of the spouses of the women in the two groups had increased significantly,and which of the spouses in the observation group were sig-nificantly higher than those of the spouses in the control group(P<0.05).The DFI of the spouses in the two groups had decrease significantly,and which of the spouses in the observation group was significantly lower than that of the spouses in the control group(P<0.05).There were no significant differences in the duration and the dosage of Gn used,and the endometrial thickness,the estradiol level on hCG day,and the numbers of oocytes retrieved and MII eggs of the women between the two groups(P>0.05).The frtilization rate,the 2PN rate,the cleavage rate,the high-quality embryo rate.and the blastocyst formation rate of the women in the observation group were significantly higher than those of the women in the control group(P>0.05).There was no significant difference in the abortion rate of the women between the two groups(P>0.05).The clinical pregnancy rates of the fresh embryo transplantation and frozen embryo transplantation(90.9%and 75.7%)and the ratio of cumulative live birth to continued pregnancy(74.0%)of the women in the observation group were significantly higher than those(46.2%,58.6%,and 45.8%)of the women in the control group(all P<0.05).Conclusion;The pancreatie kininogenase for treating the women with recurrent intra-uterine insemination failure by husband before IVF ET can improve their clinical pregnancy rate,with shorter treat-ment time and lower treatment cost,which has clinical promotion value.