Can the Prediction of Intrauterine Insemination Results by Used Aniline Blue Stain (ABS) and Sperm Chromatin Dispersion (SCD) Levels?

Introduction: This study aimed to perform routine seminal fluid analysis, sperm DNA fragmentation, and sperm function tests at the chromatin maturation level and evaluate pregnancy in the patients passing intrauterine insemination before starting Intrauterine Insemination (IUI) method. Materials and Methods: In this prospective study, 111 couples who underwent Intrauterine Insemination (IUI) in unexplained infertility patients were admitted to Al-Farah IVF and assisted reproductive center in Baghdad, Iraq between November 2020 and February 2021 were evaluated. Semen fluid analysis was performed based on (WHO 4th) guiding rules. In addition, Sperm Chromatin Dispersion (halo test) and sperm maturation were performed with Aniline Blue Stain (ABS). Results: Sperm Chromatin Dispersion (SCD) groups were compared in terms of pregnancy outcome;the positive pregnancy rate was found to be above in the normal SCD groups (p = 0.0005). In addition, Aniline Blue Stain (ABS) groups were compared in the terms of pregnancy outcome;the positive pregnancy rate was found to be higher in the normal ABS group (p = 0.017). Conclusion: Our study showed that the use of DNA fragmentation (SCD) and sperm maturation tests (ABS) together with routine semen analysis in intrauterine insemination cases will make a significant contribution to the prediction of Intrauterine Insemination (IUI) increased results. So, these results indicate a defect in the effect of DNA fragmentation on the outcome of intrauterine insemination.

Double versus single homologous intrauterine insemination for male factor infertility： a systematic review and meta-analysis

Male factor infertility affects 30%-50% of infertile couples worldwide, and there is an increasing interest in the optimal management of these patients. In studies comparing double and single intrauterine insemination （IUI）, a trend towards higher pregnancy rates in couples with male factor infertility was observed. Therefore, we set out to perform a meta-analysis to examine the superiority of double versus single IUI with the male partner＇s sperm in couples with male factor infertility. An odds ratio （OR） of 95% confidence intervals （CIs） was calculated for the pregnancy rate. Outcomes were analysed by using the ManteI-Haesel or DerSimonian-Laird model accordingto the heterogeneity of the results. Overall, five trials involving 1125 IUI cycles were included in the meta-analysis. There was a two-fold increase in pregnancies after a cycle with a double IUI compared with a cycle with a single IUI （OR. 2.0; 95% CI. 1.07-3.75; P〈O.03）. Nevertheless, this result was mainly attributed to the presence of a large trial that weighted as almost 50% in the overall analysis. Sensitivity analysis, excluding this large trial, revealed only a trend towards higher pregnancy rates among double IUI cycles （OR. 1.58; 95% CI. 0.59-4.21）, but without statistical significance （P=0.20）. Our systematic review highlights that the available evidence regarding the use of double IUI in couples with male factor infertility is fragmentary and weak. Although there may be a trend towards higher pregnancy rates when the number of IUIs per cycle is increased, further large and well-designed randomized trials are needed to provide solid evidence toide current clinical practice.

Successful pregnancy and birth after intrauterine insemination using caput epididymal sperm by percutaneous aspiration

<abstract>Aim: To manage male infertility with obstructive azoospermia by means of percutaneous epididymal sperm aspiration (PESA) and intrauterine insemination (IUI). Methods: Ninety azoospermic patients with congenital bilateral absence of the vas deferens (BAVD, n=58) or bilateral caudal epididymal obstruction (BCEO, n=32) requesting for fine needle aspiration (FNA), PESA and IUI were recruited. The obstruction was diagnosed by vasography and determination of the fructose, carnitine and alpha-glucosidase levels in the seminal fluid. Results: The mean sperm motility, density, abnormal sperm and total sperm count of the caput epdidymis were 16 %±22 %, (12±31) ×106/mL, 55 %±36 % and (16±14)×106, respectively. In the 90 couples, a total of 74 PESA procedures and 66 cycles of IUI were performed. Three pregnancies resulted, including one twin pregnancy giving birth to two healthy boys, one single pregnancy with a healthy girl and another single pregnancy aborted at week 6 of conception. The pregnancy rate per IUI cycle was 4.5 %. Conclusion: The birth of normal, healthy infants by IUI using PESA indicates that the caput epididymal sperm possess fertilization capacity. The PESA-IUI programme is a practical and economical procedure for the management of patients with obstructive azoospermia.

Treatment of Infertile Women with Unilateral Tubal Occlusion Diagnosed by Hysterosalpingography:The Role of Intrauterine Insemination

Summary:The optimal assisted reproductive treatment strategy for infertile women with unilateral tubal obstruction remains uncertain.To investigate the role of intrauterine insemination(IUI)in the treatment of infertile women with unilateral tubal occlusion,the data of 148 couples were retrospectively collected and analyzed.Seventy-eight infertile women with unilateral occlusion diagnosed by hysterosalpingography(HSG)were categorized as the study group and 70 others with unexplained infertility as the control group.The study group was divided into a proximal occlusion subgroup and a mid-distal occlusion subgroup for further analysis.The main outcomes,namely the clinical pregnancy rate(CPR),ongoing pregnancy rate(OPR),and live birth rate(LBR)per cycle,were analyzed.Our results showed a tendency of lower CPR,OPR,and LBR in the study group than in the control group,without statistical significance.Further investigations revealed that the unilateral proximal occlusion subgroup had similar CPR,OPR,and LBR as the control group,while the unilateral mid-distal occlusion subgroup had significantly lower CPR(5.1%vs.20.0%,P=0.035),OPR(5.1%vs.20.0%,P=0.035),and LBR(5.1%vs.20.0%,P=0.035)than the control group.In conclusion,the clinical outcomes of IUI were worse in patients with unilateral tubal occlusion than in those with unexplained infertility.This might be primarily caused by the worse outcome of patients with unilateral mid-distal tubal occlusion instead of proximal occlusion.

Ovarian pregnancy rupture following ovulation induction and intrauterine insemination:A case report

BACKGROUND Ovarian pregnancy after assisted reproductive technology treatment has rarely been reported;ovarian pregnancy following intrauterine insemination(IUI)is even rarer,and only nine cases have previously been reported.CASE SUMMARY We report a case of ovarian pregnancy rupture after ovulation induction and IUI.The patient presented with bilateral lower abdominal pain and was referred to the emergency department.Ultrasound examination revealed ovarian pregnancy and intraperitoneal bleeding.Laparoscopy revealed an ovarian pregnancy with hemoperitoneum,which was subsequently removed.Pelvic adhesions were detected intraoperatively,which were treated immediately.The patient spontaneously conceived an intrauterine pregnancy 3 mo later,which was ongoing at the time of writing this study.CONCLUSION Close attention should be paid to any history of pelvic inflammatory disease before commencing IUI treatment,and patients with such a history should be closely followed up after IUI.Early measurement of serumβ-human chorionic gonadotropin levels and ultrasonic examination are essential for timely diagnosis of ovarian pregnancy after ovulation induction and IUI to avoid more serious complications.

Clinical pregnancy rate of women with unexplained infertility with or without cervical mucus aspiration before intrauterine insemination: A randomized controlled trial

Objective:To detect effect of removing cervical mucus before performing intrauterine insemination(IUI)on pregnancy rate in patients with unexplained infertility.Methods:The randomized controlled trial was conducted in Infertility Division of Department of Obstetrics and Gynaecology of a tertiary care hospital.Totally 80 patients of unexplained infertility were recruited.By computer generated block randomization in block size of 4 and 6,patients were randomly allocated at time of starting ovarian stimulation into the cervical mucus removal group or the non-removal of cervical mucus group before IUI,40 in each group.Ovarian stimulation with clomiphene 100 mg from day 2-6 of menstrual cycle along with human menopausal gonadotropin 150 IU was given alternate day starting from day 7.Follicular monitoring was done and further doses given as per response;trigger was planned when 1-3 follicle reach a diameter of>18 mm.IUI was planned after trigger.IUI was done as per the group allocated.Mucus cleaning was done in the cervical mucus removal group by aspirating mucus with IUI syringe and sterile cotton swab before IUI.The primary outcome was clinical pregnancy rate.Number of difficult IUIs and cycle cancellation due to ovarian hyperstimulation were also noted.Results:IUI was not done in 4 patients due to hyperstimulation.Pregnancies per IUI cycle occurred in 7.9%(3/38)in the cervical mucus removal group and 21.1%(8/38)in the non-removal of cervical mucus group.There was no statistically significant difference in clinical pregnancy rate between two groups(P=0.19).Conclusions:There is a trend towards a lower clinical pregnancy rate with removal of cervical mucus before IUI in women of unexplained infertility though the difference is not statistically significant.Further studies with large sample size need to be done on this intervention.

Timed Intercourse versus Intrauterine Insemination with Mild Ovarian Stimulation for Unexplained Infertility

Background: Infertility is unexplained in about 22% - 28% of infertile couples. Spontaneous pregnancy may occur in them. If did not happen, Expectant management will be via clomiphene citrate (CC) administration, intrauterine insemination (IUI), and IVF & ICSI. Aim: to assess the effectiveness of intrauterine insemination with mild controlled ovarian stimulation compared with expectant management in couples with unexplained infertility more than one year. Methods: 160 couples with unexplained infertility were selected, The couples were randomly divided into two groups: Group (A) “80 couples”: Intrauterine insemination (IUI) with mild controlled ovarian stimulation (combination of CC + hMG) using prepared semen and was performed 36 hours after hCG injection, Group (B) “80 couples”: Couples had no ovulation induction. They encouraged for timed intercourse in the most fertile days of female cycle guided by folliculometry for 6 months. Data were collected quantitatively, coded and analyzed using SPSS. The power of study is 80% and 95% confidence interval. Result: The pregnancy rate was calculated in both groups: In group (A) (IUI/COS): OPR (Ongoing pregnancy rates) was 27.5% and PR (pregnancy rates)/cycle was 8.6%. In group (B) (Expectant management): OPR was 25% and PR/cycle was 5.3%. Conclusion: Mild controlled ovarian stimulation CC + hMG with IUI offers no statistical significance in terms of pregnancy outcomes over expectant management in this study however significance in the response to stimulation.

Intrauterine Insemination—Our Results between the Years 2008-2012

The purpose of this retrospective study was to determine whether or not there was a significant relationship between women’s age as a cause of sterility and pregnancy after IUI. Furthermore, we evaluated the effect of stimulation of antiestrogens and time of hCG administration on the success of IUI in relation to the age of women. During the period between 2008 and 2012, we performed a total number of 793 IUI. Patients were prepared for IUI in the natural cycle and stimulation with antiestrogens (clomiphene citrate-CC). Ovulation was induced by hCG (Ovitrelle) 40 hours before IUI or immediately after the procedure. Sperm was processed through density gradients. The average success rate of IUI was 10.2% of pregnant women per cycle. Significantly the highest number of pregnant women 16.3% was women with a diagnosis of anovulation. Significantly the lowest success rate of IUI was at the immunological cause of infertility and endometriosis. There was no evidence of age dependence for women on the success of IUI. Stimulation of CC did not significantly increase the chance of becoming pregnant. There was also no statistically significant difference in hCG before and after IUI pregnancy success. The most important group of women for whom IUI is a suitable form of assisted reproduction consists of patients of 35 years old with anovulation cause of sterility. Those patients with an immunological cause of infertility and endometriosis have significantly lower chances of conceiving after IUI and it is preferable for them to choose other techniques of assisted reproduction and embryo transfer.

加用中药周期疗法改善IUI患者妊娠结局的临床研究

[目的]观察加用中药周期疗法改善宫腔内人工授精(IUI)患者妊娠结局的临床效果。[方法]将40例行诱导排卵联合IUI的脾肾两虚型排卵障碍性不孕患者,分为中药周期疗法联合诱导排卵组(治疗组)20例,单纯诱导排卵组(对照组)20例,比较两组临床疗效、扳机日子宫内膜厚度和形态、排卵率及妊娠率。[结果]治疗组总有效率为95%,对照组为60%,两组差异有统计学意义(P<0.05)。治疗组扳机日子宫内膜厚度、A型内膜比例较对照组显著增加(P<0.05)。治疗组和对照组患者的排卵率相当(P>0.05)。治疗组妊娠率为45%,对照组为15%,两组差异有统计学意义(P<0.05)。[结论]在宫腔内人工授精周期中,使用中药周期疗法能使子宫内膜增厚,改善子宫内膜容受性,从而提高妊娠率。

Effect of Timing and Number of Intrauterine Insemination (IUI) on the Cycle Clinical Outcome

Objective To study the effect of timing and number of intrauterine insemination （IUI） per cycle on the outcome of artificial insemination by husband （AIH）. Methods A total of 195 infertile couples underwent 379 cycles of lUI with husband＇s sperm. They were divided into 4 groups according to the ovulation and the number of IUIs per cycle： single IUI was performed 24 h after hCG injection, including single IUI before ovulation （group A） and single IUI after ovulation （group B）; double IUI was performed 24 h and 48 h after hCG injection, including double IUI before and after ovulation （group C） and double IUI before ovulation （group D）. The relation-ship between IUI pregnancy rate and the factors like processed total motile sperm （PTMS）, timing and number of lUIs per cycle was analyzed. Results When PTMS〈5 × 10^6, only one case in group B got pregnant, while no pregnancy was observed in other groups. When PTMS ≥ 5 × 10^6, pregnancy rates in all group were improved significantly. The pregnancy rate in group B reached 32.22%, which was significantly higher than that in group A （14.12%）, group C （20.00%） and group D （17.39%）, respectively （P〈0.05）. Conclusion IUI treatment is recommended to be performed when PTMS ≥ 5 × 10^6. An ideal pregnancy rate can be achieved by single IUI which is performed 24 h after hCG injection, and double IUI performed without ovulation could not result in significant improvement of cycle pregnancy rate.

A new device for deep cervical artificial insemination in gilts reduces the number of sperm per dose without impairing final reproductive performance

Background: The aim of this study was to evaluate the reproductive performance of a new artificial insemination(AI) device specifically designed for gilts(Deep cervical AI, Dp-CAI) by means of which the sperm is deposited deeply in the cervix(8 cm more cranial than in traditional cervical insemination-CAI). New AI techniques have arisen in recent decades in the porcine industry, such as post-cervical artificial insemination(PCAI), which involves depositing the sperm in the body of the uterus [through a catheter(outer tube)-cannula(inner tube)] rather than by CAI. Although the PCAI method has been successfully applied in farm conditions to reduce sperm doses without impairing the reproductive performance, this technique has limitations in gilts mainly because of the difficulty involved in introducing the inner cannula through the cranial part of the cervix. For this reason, the Dp-CAI method described herein may be considered as an alternative to CAI and PCAI methods in gilts.Results: Gilts were divided in two experimental groups: 1) Dp-CAI: gilts(n = 1166) inseminated using 1.5 × 109 sperm/45 m L;2) CAI(as a control group): gilts(n = 130) inseminated using 2.5 × 10~9 sperm/85 mL. The Dp-CAI method was successfully applied in 88.90% of the gilts, with no differences detected between gilts with 1 or 2 previous oestrus cycles, although the catheter could be introduced more deeply in 2 oestrus gilts(P < 0.05). As the length of the insemination device that could not be introduced increased(at the moment of insemination), so the success rate of the Dp-CAI device fell, as did the total number of piglets born. When the reproductive output in CAI and Dp-CAI was compared, none of the parameters analysed [pregnancy and farrowing rates(%), and number of piglets born(total and live)] showed significant differences.Conclusions: The use of the Dp-CAI technique provides a new AI method as an alternative to CAI and PCAI for pigs. The device, especially designed for gilts, was used with a high degree of success reducing conventional sperm doses without impairing reproductive parameters.

Th1/Th2免疫失衡与PCOS不孕症患者IUI治疗后临床结局的关系

目的 研究辅助性T淋巴细胞亚群比值(Th1/Th2)免疫失衡与多囊卵巢综合征(PCOS)不孕症患者宫腔内人工授精(IUI)治疗后临床结局的关系。方法 前瞻性选取2019年2月至2020年12月在咸宁市中心医院进行IUI治疗的120例PCOS不孕症患者作为研究对象,根据治疗效果分为成功组(n=29),失败组(n=91)。比较两组性激素及Th1/Th2,并分析Th1及Th2水平的相关性。结果 成功组Th1、Th2、Th1/Th2显著低于失败组(P<0.05),成功组补体C3、补体C4、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平显著高于失败组(P<0.05)。相关性分析结果显示,患者的IUI治疗不良结局与Th1、Th2、Th1/Th2呈正相关。结论 Th1/Th2免疫失衡与PCOS不孕症患者IUI治疗后临床结局有显著相关性。

分析IUI助孕周期中精子超快速前向运动百分比对精子回收率及临床结局的影响

目的 探讨精子超快速前向运动百分比(SPR)在不孕不育夫妇接受宫腔内人工授精(IUI)助孕治疗过程中的临床指导意义。方法 回顾性分析2019年1月至2022年8月在我院生殖医学中心行IUI的患者162例,共237个周期患者的临床资料,根据术前精液常规分析指标SPR分为三组,分别为0≤SPR<10%(A组)、10%≤SPR<15%(B组)、15%≤SPR(C组)。分析各组的精液常规分析参数,以及接受IUI助孕治疗时优化前后的精液参数、回收率和临床结局。结果 (1)禁欲天数、精子活率和精子总活力等3个精液参数与SPR具有正相关(P<0.05),液化时间与SPR具有负相关(P<0.05)。(2)在IUI治疗周期中,优化处理前后的精液浓度和精子活率与SPR具有显著正相关性(P<0.05),但精子回收率与SPR无相关性(P>0.05);临床妊娠率与SPR也无相关性(P>0.05)。结论 不孕不育夫妇接受IUI助孕治疗时,SPR的高低对精子回收率没有显著影响,SPR也不能作为接受IUI助孕治疗患者的临床结局的直接预测因素,SPR的临床价值还需进一步探索。

不明原因不孕症患者HSG术后IUI治疗效果分析

目的:探讨子宫输卵管造影(HSG)术后不同时间对不明原因不孕症(UI)患者行宫腔内人工授精(IUI)助孕的妊娠结局影响。方法:回顾性分析弋矶山医院生殖医学科2016年1月~2021年6月UI患者行IUI共333周期,根据其行HSG与IUI的间隔时间分为2组,A组为HSG术后3个月内行IUI助孕,共157个周期,B组为HSG术后3个月以上行IUI助孕,共176个周期,分析其术后妊娠情况。结果:A组单周期妊娠率及活产率分别低于B组(14.01%vs. 22.73%,11.46%vs. 19.89%)(P<0.05),但两组间流产率(18.18%vs. 12.50%)差异无统计学意义(P>0.05)。结论:UI患者HSG术后何时行IUI均不增高其流产率,HSG术后过早行IUI助孕并不能提高UI患者单周期妊娠率及活产率。

不同治疗方案对卵巢储备功能正常年轻女性夫精人工授精妊娠结局的影响

目的探讨不同治疗方案对年龄<35岁卵巢储备功能正常女性夫精人工授精(AIH)妊娠结局的影响。方法回顾性分析2015年1月至2021年8月在本中心行AIH助孕的年龄<35岁卵巢储备功能正常女性的3024个周期的临床资料。根据治疗方案分为6组:自然周期组(NC组,n=380)、克罗米芬组(CC组,n=57)、CC联合促性腺激素(Gn)组(CC+Gn组,n=78)、Gn组(n=1712)、来曲唑组(LE组,n=430)以及LE联合Gn(LE+Gn组,n=367),比较各组患者的一般情况和妊娠结局,并采用多因素Logistic回归分析影响AIH临床妊娠率及活产率的相关因素。结果一般情况比较:6组间体质量指数(BMI)、窦卵泡数(AFC)、基础卵泡刺激素(FSH)水平、优势卵泡数、不孕因素整体比较有统计学差异(P<0.05),而女方年龄、不孕年限、不孕类型及精液处理方式比较均无统计学差异(P>0.05)。妊娠结局比较:6组患者间临床妊娠率和活产率整体比较有统计学差异(P<0.05),其中LE+Gn组的临床妊娠率和活产率显著高于NC组(分别为20.7%vs.9.5%;16.3%vs.7.4%)(P<0.05);6组间流产率、异位妊娠率及多胎率比较无统计学差异(P>0.05)。多因素Logistic回归分析结果显示,矫正混杂因素后,LE+Gn治疗方案和优势卵泡数均是临床妊娠和活产的保护因素(OR>1,P<0.05),而不孕年限是临床妊娠和活产的危险因素(OR<1,P<0.05)。结论LE联合Gn方案可显著提高AIH的临床妊娠率和活产率,可作为年龄<35岁卵巢储备功能正常女性AIH助孕的首选治疗方案。

Iowa 循证实践模式在宫腔内人工授精术后患者卧床时间中的应用

目的将宫腔内人工授精术后卧床休息时间最佳证据应用于临床并评价其效果。方法采用Iowa循证实践模式指导开展宫腔内人工授精术后卧床休息时间指导的实践,比较证据应用前后患者的舒适度、临床妊娠率、医护人员的相关知识水平以及各审查指标的执行率。结果证据应用后,患者舒适度及临床妊娠率未下降,差异无统计学意义(P>0.05),医护人员的知识水平有所提升(P<0.05),医护人员对新证据的执行率达到了100%,患者对新证据的执行率达到了83.53%及以上。结论宫腔内人工授精术后缩短卧床休息时间并不影响临床妊娠率,通过循证实践进一步提升了医护人员相关知识水平,优化了护理流程。

低体质指数不利于不明原因原发不孕患者人工授精诱导排卵周期妊娠结局

【目的】探索女方体质指数(BMI)对不明原因原发不孕女性人工授精诱导排卵周期(OI-IUI)妊娠结局的影响。【方法】回顾性分析2016年1月至2022年12月于中山大学孙逸仙纪念医院生殖中心行OI-IUI助孕的不明原因原发不孕夫妻共764个周期的临床资料。按照女方患者BMI分为3组,低BMI组(消瘦,BMI<18.5 kg/m^(2))、正常BMI组(正常体质量,18.5 kg/m^(2)≤BMI<23.0 kg/m^(2))、高BMI组(超重、肥胖,BMI≥23.0 kg/m^(2)),比较各组间一般资料以及妊娠结局。采用单因素分析和Logistic回归分析矫正混杂因素,探讨BMI与OI-IUI活产率的相关性。【结果】三组HCG阳性率(7.08%、9.74%、13.19%)、宫内妊娠率(5.51%、7.91%、13.19%)和活产率(4.72%、6.90%、12.50%)由低BMI组到高BMI组依次递增,早期流产率(14.28%、10.26%、5.26%)则是由低BMI组至高BMI组依次递减,其中高BMI组活产率明显高于低BMI组及正常BMI组,差异有统计学意义(P=0.034)。根据二元Logistic回归分析显示,BMI是影响活产的独立影响因素,与低BMI相比,高BMI可提高活产率(OR=3.15,95%CI=1.191,8.329,P=0.021)。【结论】低BMI不利于不明原因原发不孕女性OI-IUI妊娠结局,对该部分患者鼓励以健康方式进行合理增重。

影响不孕妇女IUI治疗成功率的因素分析

目的:探讨影响IUI治疗成功的各种临床因素。方法:回顾性分析260例接受IUI治疗妇女的促排卵方案、子宫内膜厚度、优势卵泡的数目和直径、IUI的时机、输卵管壶腹部的直径、输卵管伞端距宫角的距离、洗涤后精子的密度和精子的动力、IUI的周期数、AsAb与妊娠结局的关系。结果:IUI治疗结局与子宫内膜的厚度、IUI治疗的时机、输卵管壶腹部的直径、输卵管伞端距宫角的距离、洗涤后精子的密度和动力有关(P<0.01,P<0.05)。与促排卵方案、优势卵泡的数目和直径、抗精子抗体无关(P>0.05)。1-3个周期IUI治疗的妊娠率明显高于3个以上治疗周期的妊娠率(P<0.05)。结论:影响IUI结局的主要因素是:子宫内膜的厚度、IUI治疗的时机、输卵管壶腹部的直径、输卵管伞端距宫角的距离、洗涤后精子的密度和动力。延长IUI治疗的周期数,并不能提高病人的成功率。

WHO第5版精液参考值标准的临床应用对IUI适应证谱的影响

目的：探讨WHO第5版精液参考值标准的调整对夫精宫腔内人工授精（IUI）适应证谱的影响。方法：回顾性分析我院生殖中心2012年1-7月采用WHO第4版标准111个周期IUI的临床资料（A组），和2013年1-7月采用WHO第5五版标准84个周期IUI的临床资料（B组），统计各种适应证所占百分率。结果：两组适应证比较，弱精子症差异有统计学意义[97个周期（87．4％）／3547个周期（55．9％），P〈0．05]。少精子症（0W0）、畸形精子症[57个周期（51．4％） vs 30个周期（35．7％）]、液化异常[1个周期（0．9％） vs 0]、性功能障碍及生殖器畸形[0V．53个周期（3．6％）]、免疫性不育[1个周期（0．9％） vs 0]和不明原因不育[4个周期（3．6％）V．52个周期（2．4％）]差异无统计学意义（P均〉0．05）。结论：WHO第5版精液参考值标准的临床应用对IUI适应证谱有较大影响，造成因为男方因素行IUI的病例大幅度减少，可能会使部分患者治疗周期加长，女方诊治过度，进一步加重其经济负担和身心压力。