高龄非输卵管性不孕妇女不同助孕方案妊娠结局的比较

目的为高龄非输卵管性不孕女性推荐更合理的助孕方案。方法选择行宫腔内人工授精(intrauterine insemination,IUI)和体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)的1 312名高龄输卵管通畅不孕女性(年龄≥35岁患者)共2 094个周期进行回顾性分析,其中IUI组827个周期,IVF组启动周期1 267个,移植周期798个。根据患者的年龄层次分为35~37岁,38~39岁和≥40岁3组,回顾性分析各组的临床资料和助孕结局。结果 3个不同年龄层的IUI组临床妊娠率分别为10.78%、8.72%和4.14%,IVF-ET组的移植周期临床妊娠率分别为53.03%、47.51%和22.69%,IUI和IVF组内及组间各年龄层临床妊娠率比较,差异有统计学意义(P0.05)。结论随着患者年龄的增加,IUI和IVF两种助孕方案的临床妊娠率均明显降低,建议年龄≥40岁输卵管通畅的不孕女性应积极行IVF治疗。

Comparison of pregnancy outcome of different assisted reproductive protocols for non-tubal infertility in women with advanced age

Objective To recommend a reasonable assisted reproductive protocol for non-tubal infertility women with advanced age.Methods.A total of 2 094cycles from 1 312 non-tubal infertility women who were 35 years old or older and performed intrauterine insemination/in vitro fertilization and embryo transfer (IUI/IVF) were included.The patients were divided into 2 groups:IUI group (827 cycles) and IVF group (1 267 initiating cycles and 798 embryo transfer cycles).They were further divided into three age subgroups according to their age:35-37,38-39,and ≥40 years old,then the clinical outcomes of each group were analyzed,retrospectively.Results The clinical pregnancy rates of three age levels in IUI group were 10.78％,8.72％,4.14％,respectively;and in IVF-ET group were 53.03％,47.51％,22.69％,respectively.There were statistical significances in the clinical pregnancy rates of the two groups in different age subgroups (p＜ 0.05).Conclusion With the increase of age,the clinical pregnancy rates of IUI and IVF were significantly decreased,which is more obvious in women over 40 years.So we suggest that when women who are older than 40 years old without tubal factor should be advised to try IVF treatment.