影响男性不育官腔内人工授精妊娠率的因素分析

目的探讨影响男性不育患者行宫腔内人工授精（IUI）临床妊娠的相关因素。方法回顾性分析337对不孕夫妇因男性因素行IUI共667周期的资料，分析男女双方年龄、不孕年限、女方体重指数（BMI）、促排卵方案以及处理后前向运动精子总数（PTMS）对临床妊娠率的影响。结果女方年龄≥35岁者临床妊娠率为12．6％，显著低于年龄〈30岁者；男方年龄≥35岁者临床妊娠率为15．9%，显著低于年龄〈35岁者；克罗米芬联合促性腺激素周期临床妊娠率为25．5％，显著高于自然周期；PTMS〈5×10^6临床妊娠率为8．3％，显著低于PTMS≥10×10^6（P〈0．05）。结论男性不育患者行IUI治疗过程中需要充分考虑男女双方年龄对治疗结局的影响，适时选择促排卵方案，以提高临床妊娠率；当PTMS〈5×10^6，IUI妊娠率显著下降，建议行IVF-ET／ICSI—ET治疗以改善妊娠结局。

Influencing factors of pregnancy rate of intrauterine insemination with male infertility

Objective To study the relative factors affecting the clinical pregnancy rate of intrauterine insemination （IUI） with infertility caused by men. Methods The clinical data of 337 infertile couples who undergoing 667 IU cycles were analyzed. Relationship between clinical pregnancy rate and couples＇ age, duration of infertility, maternal body mass index （BMI）, ovulation induction and processed total motile sperm count （PTMS） were investigated. Results The clinical pregnancy rate was significantly lower in the patients with female and male age ≥35 years （12.6% and 15.9% respectively） ; Compared with natural cycles, the clinical pregnancy rate was statistically higher （25.5%） in clomiphene （CC） combined with gonadotrophin cycles; When PTMS 〈5 × 10^6, the clinical pregnancy rate was dramatically decreased （8.3%, P〈0.05）. Conclusions The age of female and male should be considered during IUI therapy, optimal ovulation can help to increase the clinical pregnancy rate. The clinical pregnancy rate will statistically decrease when PTMS〈5 × 10^6 , the patients can choose IVF - ET or ICSI - ET to improve the outcome.