子宫内膜异位症不孕患者术后半年人工授精的效果

目的：探讨宫腔内人工授精（IUI）在子宫内膜异位症（EMs）不孕患者腹腔镜术后半年的应用价值。方法：选择2010年1月—2012年12月在中山大学附属中山市人民医院不孕专科门诊就诊，经过常规系统检查后，行腹腔镜手术诊断为Ⅰ~Ⅲ期EMs并已进行手术治疗的不孕妇女98例，按患者意愿分为期待组42例、自然周期+宫腔内人工授精（NC+IUI）组38例、控制性促排卵+宫腔内人工授精（COS+IUI）组18例。比较术后半年的妊娠情况。结果：期待组周期妊娠率6.1%（12/197），半年累积妊娠率28.6%（12/42）。NC+IUI组周期妊娠率6.6%（4/61），半年累积妊娠率10.5%（4/38）。COS+IUI组周期妊娠率14.8%（4/27），半年累积妊娠率22.2%（4/18）。3组周期妊娠率和累积妊娠率比较，差异无统计学意义（P＞0.05）。结论：Ⅰ~Ⅲ期EMs不孕患者术后半年积极给予IUI的妊娠率与期待治疗相当，但此结论有待增加样本量进一步探讨。

IUI Outcomes in Patients with Endometriosis in Half Year after Laparoscopic Treatment

Objective: To investigate the clinical outcomes of intrauterine insemination （IUI） in infertility women with endometriosis in half year after laparoscopic treatment. Methods：Ninety-eight patients with endometriosis （stage Ⅰ-Ⅲ） treated by laparoscopy, from January 2010 to December 2012 at Zhongshan People′s Hospital, were divided into three groups: nature cycle plus IUI（NC+IUI）, controlled ovarian hyperstimulation plus IUI（ＣＯＳ＋ＩＵＩ）， and expectant treatment without IUI（ET control）, with the informed consent. The pregnancy rates of three groups in half year after operation were compared. Results：The pregnancy rate per cycle, and the cumulative pregnancy rate in half a year were 6.1%（12/197） and 28.6%（12/42） in the ET control group, 6.6%（4/61） and 10.5%（4/38） in the NC+IUI group, and 14.8%（4/27） and 22.2%（4/18） in the COS+IUI group. Interestingly, there were no significant differences in those rates among three groups（P＞0.05）. Conclusions：There is not significant difference in the pregnancy rate in those infertility patients with endometriosis （stage I-III） in half year after the laparoscopic treatment combined with IUI and without IUI （expectant treatment）. Of course, it is necessary to study further with more samples.