夫精宫腔内人工授精手术时机和妊娠相关性分析

目的：探讨夫精宫腔内人工授精（IUI）时机及次数与妊娠率的关系。 方法：回顾性分析851对在广州医科大学附属第三医院行夫精IUI治疗的不孕夫妇（共1 751个周期），根据手术时机及次数，分为排卵前1次IUI、排卵后1次IUI、排卵前2次IUI、排卵前后各1次IUI 4组，比较4组妊娠率的差异。 结果：排卵前、后行单次IUI组的妊娠率分别为11.21%和12.23%；排卵前行单次IUI后有排卵组妊娠率显著高于无排卵组（P＜0.05）。排卵前后各行1次IUI、排卵前行2次IUI妊娠率分别为16.21% 和15.65%；排卵前行2次IUI后有排卵组临床妊娠率（17.14%）高于无排卵组（0.00%），差异有统计学意义（确切概率法 P=0.040）。有排卵周期中，排卵前1次、排卵后1次、排卵前2次、排卵前后各1次IUI的临床妊娠率分别为10.99%、12.23%、17.14%、16.21%，行2次IUI组的妊娠率虽然高于行1次IUI组，但差异无统计学意义（P＞0.05）。 结论：只要确定卵泡破裂，排卵前后行IUI、行1次或2次IUI妊娠率无差异；但IUI后卵泡无破裂，则妊娠率为0～2.85%，因此针对2个周期IUI出现未破裂卵泡黄素化综合征者建议转行体外受精。

Analysis of Correlation between Surgical Timing and Pregnancy Outcomes of Intrauterine Artificial Insemination

Objective: To investigate the correlation between the surgical timing of insemination and the pregnancy rate of intrauterine artificial insemination (IUI). Methods:The retrospective analysis was designed in 851 infertile couples with male factors who were treated with IUI (a total of 1 751 cycles). Those cycles were divided into four groups as follows: Group 1 was one time of IUI before ovulation, Group 2 was one time of IUI after ovulation, Group 3 was two times of IUI before ovulation, and Group 4 was two times of IUI before and after ovulation individually. The pregnancy rates of four groups were then compared accordingly. Results: The pregnancy rates in group 1 and group 2 were 11.21%and 12.23%, while in group 1 the pregnancy rate in couples with ovulation after IUI was significantly higher than that in those couples with anovulation (P<0.05). The pregnancy rates in group 3 and group 4 were 16.21%and 15.65%, while in group 3 the pregnancy rate in couples with ovulation after IUI was significantly higher than that in those couples with anovulation (17.14%vs. 0.00%, P=0.040). In the ovulatory cycles of four groups, the pregnancy rates were 10.99%, 12.23%, 17.14% and 16.21%respectively (P>0.05). The pregnancy rate of two times of IUI was higher than that of one time of IUI (although P>0.05). Conclusions: There are not significant difference in the pregnancy rate in those couples with ovulation before or after IUI treatment, 1 or 2 times of IUI. However, the pregnancy rate is very low in those couples without ovulation before or after IUI treatment (0~2.85%). Those women with the luteinized unruptured follicle syndrome (LUFS) during two cycles of IUI should be advised to treat with in vitro fertilization (IVF).