超排卵对宫腔内人工授精周期妊娠率的影响

目的分析超排卵对人工授精结局的影响，探讨超排卵对不同人群治疗的有效性。方法回顾性分析我院生殖科2000年3月-2007年12月期间女方有自发排卵的739个人工授精周期，比较不孕原因、女方年龄、有无子宫内膜异位症等因素下超排卵与自然周期妊娠率。结果739个人工授精周期中，超排卵周期233个，自然周期506个，妊娠率分别为21．6％和13．5％（P〈0.05），不孕因素中，宫颈因素为378个，男性因素为100个，盆腔输卵管因素44个，子宫内膜异位症85个，不明原因132个，其中宫颈因素和不明原因不孕周期超排卵周期妊娠率明显高于自然周期（22．40％，14．62％；27．03％，12．63％ P〈0.05）；男性因素、输卵管因素、子宫内膜异位症、女方年龄大于37岁周期，超排卵与自然周期妊娠率差异无显著性（P〉0.05）。超排卵周期中，氯米芬与促性腺素周期临床妊娠率无显著差异（P〉0.05）。结论因宫颈因素、不明原因不孕行人工授精夫妇超排卵周期妊娠率高，而男性因素、子宫内膜异位症、盆腔输卵管因素或年龄大于37岁妇女进行人工授精时慎重选择排卵诱导。

Effect of ovarian hyperstimulation on pregnant rate in intrauterine insemination

Objective To assess the effects of ovarian hyperstimulation(OH)on pregnant rate in intrauterine insemination(IUI).Methods In this retrospective study,739 IUI cycles from March 2000 to December 2007 were studied.Cycle clinical pregnancy rates(PR)were compared between OH and natural cycles.Results There were 233 OH cycles and 506 natural cycles among 739 IUI cycles.The pregnancy rates were 21.6% and 13.5%,respectively(P<0.05).In OH cycle,clinical PR is significantly higher than natural cycle in patient with cervical-factor(22.4% vs.14.62%,P<0.05)and unknown reason infertility(27.03% vs.12.63%,P<0.05).The clinical PR was comparable in OH and natural cycles in couples with semen defects,endometriosis or pelvic factor.In groups older than 37 years old,clinical PR was comparable in OH and natural cycle.Conclusions The data from our study suggests that OH has the additional value in IUI for groups with cervical-factor and unknown reasons infertility.In couples with semen defects,endometriosis,pelvic factor or women age more than 37,IUI with OH leads to pregnancy rates comparable to those without OH.