影响供精人工授精成功率因素及最佳治疗方案探讨

目的：探讨影响供精人工授精(AID)成功率的因素及其最佳治疗方案。方法：98对夫妇行131个AID周期，其中8例行AID联合促排卵治疗3个周期以上未孕，遂改为ICSI。结果：AID共20例妊娠，且均发生在第1—3个周期，周期妊娠率为15．3％。女性患者年龄大于35岁和不孕年限大于10年的妊娠率显著降低。精子活动率在处理前妊娠组和非妊娠组相似，而处理后妊娠组显著高于非妊娠组(0．02＜P＜0．05)。每周期定时授精1次与2次的妊娠率无显著差异(P＞0．05)。8对夫妇行10个供精ICSI周期，有5例妊娠，周期妊娠率为50．0％。结论①无精子症患者的治疗首选供精AID；②AID的妊娠率随女性患者年龄的增长和不孕年限的延长而下降；③增加授精频率并不提高妊娠率；④当AID联合促性腺激素3个以上周期未孕时，ICSI将是最佳选择。

Study on the factors effecting success rate of artificial insemination by donor and the treatment protocol investigation

Objective To study the factors effecting success rate of AID and to explore the best treatment protocol.Methods A total of 98 infertile couples with azoospermia enlisted for AID and finished 131 cycles.Eight patients who had experienced more than three times AID in combination with hMG were failed to pregnancy,then changed to ICSI.Results Twenty pregnancies gained in 131 AID cycles,the pregnancy rate per cycle was 14.5%.The women who older than 35 and the infertility duration longer than 10 years had lower pregnancy rate,which were 5.0% and 4.3% respectively.The percentage of sperm motility were distinctly improved after Percoll gradient centrifugation,and were statistically different between pregnacy group and non pregnancy group (0.02< P <0.05).Eight couples who had undergone 10 ICSI cycles with donor semen acquired 5 pregnancies,the pregnancy rate per cycle was 50%.Conclusions AID is very effetive method for the treatment of azoospermia.It may be improved in case of combined with hMG.If it fails to conceive when experinced more than three times AID with hMG,ICSI is the best way.