高龄女性自然周期和促排卵周期人工授精结局的比较

目的比较高龄妇女自然周期和促排卵周期的人工授精结局并分析其影响因素。方法回顾性分析580例高龄女性人工授精周期的临床资料,其中自然周期201例,促排卵周期379例,比较两者的成熟卵泡数、妊娠率、流产率等,并分析其受不同促排卵方案和不同不孕原因的影响。结果自然周期与促排卵周期的生化妊娠率(8.45%vs 11.60%)、临床妊娠率(7.46%vs 10.29%)、异位妊娠率(0vs 2.56%)差异无统计学意义(P>0.05),但自然周期流产率(8/15,53.33%)高于促排卵周期流产率(7/39,17.95%)(P<0.05)。不同促排卵方案的成熟卵泡数量,CC组(1.87±0.85)、CC+HMG组(1.80±0.75)高于LE组(1.29±0.53)、LE+HMG组(1.38±0.63)、HMG组(1.35±0.60)、rFSH组(1.35±0.48)(P<0.05);临床妊娠率CC组(1/23,4.35%)低于其他组(P<0.05);各促排卵组的流产率无统计学差异(P>0.05)。自然周期与促排卵周期患者各种不孕原因的临床妊娠率无统计学差异(P>0.05)。结论高龄女性的自然周期流产率高于促排卵周期流产率;高龄女性采取合适的促排卵方式可以提高宫腔内人工授精成功率。

Comparison and analysis of pregnancy outcome of intrauterine insemination in natural cycles and ovulation cycles of advanced age women

Objective To compare the pregnancy outcomes of intra-uterine insemination(IUI)in natural cycles and ovulation cycles of advanced age women and analyze the influencing factors.Methods The clinical data and pregnancy outcomes of 580 IUI cycles in advanced age women were retrospectively analyzed,including 201 natural cycles and 379 ovulation cycles.The mature follicle number,pregnancy rate,abortion rate were compared,and the effects of different ovulation induction protocols and different infertility causes were analyzed.Results There was no significant difference in the biochemical pregnancy rate(8.45%vs 11.60%),clinical pregnancy rate(7.46%vs 10.29%),and ectopic pregnancy rate(0%vs 2.56%)between the natural cycles and the ovulation cycles(P>0.05),but the abortion rate of natural cycles(8/15,53.33%)was significantly higher than that of ovulation cycles(7/39,17.95%)(P<0.05).In different ovulation induction protocols,the number of mature follicles of CC group(1.87±0.85),CC+HMG group(1.80±0.75)were significantly higher than those of LE group(1.29±0.53),LE+HMG group(1.38±0.63),HMG group(1.35±0.60)and rFSH group(1.35±0.48)(P<0.05).The clinical pregnancy rate of the CC group(1/23,4.35%)was significantly lower than that of the other groups(P<0.05).There was no significant difference in the abortion rate between those ovulation induction groups(P>0.05).There was no statistical difference in the clinical pregnancy rate between the natural cycles and the ovulation cycles(P>0.05).Conclusions The abortion rate of natural cycles of advanced age women is significantly higher than that of ovulation cycles.The appropriate methods of ovulation induction for advanced age women can improve the IUI live birth rate.