处理后精液参数对夫精人工授精结局的影响

目的探讨精子形态学变化及处理后前向运动精子总数(PTMS)对以男性因素为主的宫腔内人工授精(IUI)妊娠结局的影响。方法回顾性分析163例共266个男性因素为适应证的IUI周期,依照注入活动精子数分比较各组妊娠率,同时按Krüger’s精子形态学严格标准法比较精子正常形态率对IUI妊娠率的影响。结果 266个周期中,临床妊娠39周期,周期妊娠率为14.66%,PTMS<10×106(A组)、10×106≤PTMS<20×106(B组)、PTMS≥20×106(C组)这三组发热妊娠率分别为8.57%、12.87%和21.05%,其中A组和C组比较差异具有统计学意义(P<0.05),而精子正常形态<2%(Ⅰ组)、2%~4.5%(Ⅱ组)、5%~14.5%(Ⅲ组)、≥15%(Ⅳ组)这四组的妊娠率分别为3.03%、15.23%、15.11%和20.83%,第Ⅰ组和第Ⅳ组比较具有统计学意义(P<0.05)。结论在男性因素为主的IUI周期中,精子正常形态率<2%及精液处理后PTMS<10×106时周期临床妊娠率明显下降。

Effect of processed spermatozoa parameter on the outcome of intrauterine insemination

Objective To assess the effect of morphological changes of sperm and processed total motile sperm(PTMS) count on the outcome of intrauterine insemination(IUI).Methods A retrospective study was performed on 163 couples who underwent 266 IUI cycles.The pregnancy rates were compared according to the number of PTMS and the percentage of morphologically normal spermatozoa.Results A total of 39 clinical pregnancies were obtained in 266 treated cycles,with a pregnancy rate of 14.66%.The pregnancy rates were 8.57%,12.87% and 21.05% for groups with PTMS<10×106(group A),10×106 ≤PTMS<20×106(group B) and PTMS≥20×106(group C),respectively,with statistically significant difference betwwen group A and group C(P<0.05).The pregnancy rates were 3.03%,15.23%,15.11% and 20.83% for groups with the percentage of normal sperm <2%(groupⅠ),2%~4.5%(groupⅡ),5%~14.5%(group Ⅲ) and ≥15%(group Ⅳ),with statistically significant difference between groupⅠ and group Ⅳ(P<0.05).Conclusion The clinical pregnancy rate declined distinctively when PTMS<10×106,and sperm morphology was a significant factor that affects the success of IUI with male factor infertility.