自然月经周期供精人工授精临床妊娠率的影响因素

目的:探讨如何提高自然月经周期宫颈内人工授精(AID)妊娠率。方法:回顾性分析AID986个周期的女方年龄、解冻精子复苏率、卵泡直径、子宫内膜厚度、同一周期授精次数与周期临床妊娠率的关系。结果:周期临床妊娠率为18.15%。多因素Logistic回归分析显示女方年龄、同一周期授精次数是影响自然周期供精人工授精妊娠率的主要因素。按年龄分为<30岁组、30-35岁组和>35岁组,各组周期临床妊娠率分别为21.86%、13.04%和6.15%,两两比较有显著差异(P=0.000)。同一周期单次授精周期临床妊娠率(16.3%)低于双次授精者(27.85%),P=0.000;排卵前授精者(20.87%)略高于排卵后授精临床妊娠率(15.57%),但二者无统计学差异(P=0.165)。结论:女方年龄和同一周期授精次数是影响自然月经周期宫颈内AID临床妊娠率的主要因素,30岁以后临床妊娠率明显下降,同一周期双次授精可提高临床妊娠率。

Factors Affecting the Pregnancy Rate of Artificial Insemination with Donor Spermatozoa under Unstimulated Cycles

Objective: To explore the factors which affect the pregnancy rate of artificial insemination with donor sperm (AID) under unstimulated cycles using intra-cervical insemination. Methods: A total of 986 treatment cycles in intra-cervical insemination AID was enrolled. The relationship was retrospectively analyzed between pregnancy rate and five factors such as women’s age, sperm motility after thawing, follicular average diameter, thickness of endometrium and the number of insemination per cycle. Results: Average clinical pregnancy rate per intra-cervical insemination AID cycle was 18.15%. Pregnancy rate in the groups of women’s age under 30, from 30 to 35, above 35 reached 21.86%, 13.04% and 6.15%, respectively. The difference was statistically significant (P=0.000). Among above five factors, women’s age and the numbers of insemination per cycle were considered as two main factors through logistic regress analysis. Pregnancy rate in once insemination per cycle (16.3%) was lower than that in twice insemination per cycle (27.85%). There also existed statistically significant different between the above two groups (P=0.000). Conclusion: Women’s age and the times of insemination per cycle were the two important determinants for success rate in intra-cervical insemination AID treatment. If women’s age is above 30, the pregnant rate per cycle will be decreased obviously. But twice insemination per cycle can also improve the clinical pregnancy rate.