供精人工授精的临床应用价值

目的:探讨供精人工授精(AID)的临床应用价值。方法:回顾性分析2008年1月至2009年3月在本中心治疗的258对夫妇共行480个AID治疗周期,根据女方年龄分成≤30岁和≥31岁两组。结果:480个AID治疗周期共获得120例临床妊娠,周期妊娠率为25.00%,累积妊娠率达46.51%。≤30岁和≥31岁两组在自然周期方案中周期妊娠率分别是29.65%、13.33%,累积妊娠率分别是51.00%、25.00%,两者间差异均有显著性(P<0.05);在促排卵方案中,两组周期妊娠率分别为24.02%、23.81%,累积妊娠率分别为48.86%、43.48%,差异均无显著性(P>0.05)。随着女性年龄增长,不孕年限延长,两组AID的周期妊娠率和累积妊娠率下降,但是无统计学差异。前4个周期的周期累积妊娠率分别为24.03%、24.94%、24.69%和25.00%,无明显差异(P>0.05);第一周期与后三个治疗周期的累积妊娠率分别是24.03%、39.53%、45.74%和46.51%,有显著升高趋势(P<0.01)。结论:①在AID治疗中女方年龄增高,促排卵授精方案优于自然周期授精方案。②AID至少应进行3～4次,未成功者再求助于试管婴儿等其他辅助生殖技术。

Clinical value of artificial insemination by donor

Objective:To investigate the clinical value of artificial insemination by donor(AID).Methods:We retrospectively analyzed 480 cycles of AID among 258 infertile couples,who were divided according to the women's age into a≤30 yr group and a≥31 yr group.Results:A total of 120 pregnancies were achieved in 480 AID cycles,with a cycle pregnancy rate of 25.00%and a cumulative pregnancy rate of 46.51%.In the natural cycles,the cycle pregnancy rate was 29.65% and the cumulative pregnancy rate was 51.00% in the≤30 yr group,significantly higher than 13.33% and 25.00%in the≥31 yr group(P＜0.05).In the ovulation induction cycles,no significant differences were found in the cycle and cumulative pregnancy rates between the two groups (24.02 and 48.86% versus 23.81 and 43.48%,P＞0.05).The cycle and cumulative pregnancy rates decreased with the increase of infertility duration and the women's age,but had no significant differences.In the first four cycles,the cycle pregnancy rates were 24.03,24.94,24.69 and 25.00%(P＞0.05),and the cumulative pregnancy rates were 24.03,39.53,45.74 and 46.51%,with significant differences between the first cycle and the other three(P＜0.01).Conclusion:Ovulation induction is superior to natu ral cycle in AID for older women.IVF/ICSI can be resorted to only after AID has failed three or four times.