影响夫精宫腔内人工授精临床妊娠率的相关因素分析

目的探讨影响夫精宫腔内人工授精（IUI）临床妊娠率的各种相关因素。方法回顾性分析本生殖中心215例患者进行的488个IUI治疗周期,对女方年龄、不孕年限、不孕病因、IUI周期次数、用药方案、HCG/LH（＋）日成熟卵泡数和内膜厚度、授精时机以及注入宫腔内的前向活动精子数（TMS）和妊娠结局的关系进行分析。结果共获得临床妊娠78例,周期妊娠率16.0%,患者妊娠率36.3%。其中患者年龄的增长、子宫内膜厚度〉14mm、人授时已排卵者妊娠率显著下降;IUI周期次数的增加≥5周期、TMS〈5×106患者的妊娠率也有下降的趋势;男方少弱精子症和子宫内膜异位症患者的妊娠率显著低于宫颈因素和多次促排卵不孕（不明原因？）的患者;患者的不孕年限、用药方案、HCG/LH（＋）日成熟的卵泡数对妊娠结局无显著影响,但卵泡个数为3个的妊娠率有增高的趋势。结论女方年龄、子宫内膜厚度、授精时机及不孕因素是影响IUI结局的重要因素,IUI周期次数、成熟卵泡数、注入宫腔的TMS对妊娠结局也有一定的影响。

The analysis of relevant factors influencing on the clinicalpregnancy rate of intrauterine insemination with husband sperm

Objective: To investigate the relevant factors influencing on the clinical pregnancy rate of intrauterine insemination(IUI) with husband sperm.Methods: 488 cycles of 215 patients with IUI were retrospectively evaluated according to the age of female,duration of infertility,indication for IUI,frequency of insemination,ovulation induction protocol,number of follicles on HCG/LH(+) day and endometrial thickness,time of insemination and postwash total motitle sperm(TMS).Results: Totally 78 patients received clinical pregnancies,clinical pregnancy rate(CPR) was 16.0% per cycle and 36.3% per patient.The clinical pregnancy rates were significantly lower in patients with more aged,endometrial thickness>14mm,insemination after ovulation.The trends toward a lower CPR were found with frequency of IUI≥5 times and TMS<5×106.The clinical pregnancy rates of mild and moderate oligozoospermia and asthenozoospermia and endometriosis were significantly lower than those of cervix factor and no pregnancy through more than 3 times ovulation.Duration of infertility,ovulation induction protocol,number of follicles on HCG/LH(+) day did not influncenced on the PCR,but the PCR of 3 follicles was higher.Conclusion: The age of female,endometrial thickness,time of insemination are important factors to the CPR of IUI.The frequency of insemination,numbers of follicles and posrwash TMS also have some influence on IUI success.