促排卵对不同病因宫腔内人工授精的结局分析

发布时间：2018-01-31 22:50

本文关键词： 宫腔内人工授精(IUI) 自然周期(NC) 促排卵周期(OIC) 临床妊娠率活产率　出处：《生殖与避孕》2016年10期 　论文类型：期刊论文

【摘要】：目的:探讨促排卵对不同病因不孕患者人工授精的影响。方法:回顾性分析因男性因素、输卵管盆腔因素、子宫内膜异位症(EMS)和不明原因进行人工授精患者的资料,根据患者进行自然周期或促排卵周期分组,比较不同周期组的临床妊娠率和活产率。采用多元回归分析模型校正患者年龄、不孕年限、不同因素构成比、基础FSH、LH、E_2、子宫内膜厚度、类型、宫腔内人工授精(IUI)日卵泡直径及男性前向运动精子总数。评估在男性因素、输卵管盆腔因素、EMS和不明原因中促排卵周期与临床妊娠率的关系。结果:①促排卵组患者平均年龄、不孕年限以及不孕因素构成比(男性因素、输卵管盆腔因素、EMS和不明原因)与自然周期比较,无统计学差异(P0.05),而临床妊娠率和活产率均高于自然周期,但无统计学差异(P=0.08);②通过多元因素回归分析校正了年龄、基础内分泌水平、不孕因素、内膜厚度和类型及前向运动精子总数等混杂因素后,促排卵周期相对于自然周期依然有显著优势(OR=1.607;95%CI=1.115~2.316);③在不同因素不孕患者中,促排卵周期可提高输卵管盆腔因素患者的活产率(OR=4.56;95%CI=1.53~13.53)。结论:促排卵周期可提高输卵管盆腔因素患者宫腔内人工授精的临床妊娠和活产率。
[Abstract]:Objective: to investigate the effect of ovulation promotion on artificial insemination in infertile patients with different etiology. The data of patients with endometriosis (EMSs) and patients with artificial insemination for unknown reasons were divided into groups according to the patients' natural cycle or ovulation promoting cycle. The clinical pregnancy rate and live delivery rate were compared in different cycle groups. Multivariate regression model was used to calibrate the patients' age, infertility years, ratio of different factors composition, basic FSHLHHHG E2, endometrial thickness. Type intrauterine intrauterine insemination IUI day follicle diameter and total number of male forward motility spermatozoa evaluated in male factors and tubal pelvic factors. Results the mean age, infertile years and the ratio of infertile factors (male factors, pelvic factors) in the ovulation promoting group were significantly higher than those in the control group (male, oviduct and pelvic factors), the relationship between ovulation induction cycle and clinical pregnancy rate was found in EMS and unexplained reasons. There was no statistical difference between EMS and the natural cycle, but the clinical pregnancy rate and the live birth rate were higher than those of the natural cycle, but there was no statistical difference between the clinical pregnancy rate and the live birth rate, but there was no statistical difference between the clinical pregnancy rate and the live birth rate. 2After multivariate regression analysis, the mixed factors such as age, basal endocrine level, infertility, intimal thickness and type, and total number of forward motile sperm were corrected. The ovulation promoting cycle still has a significant advantage over the natural cycle. (95) CII 1.115 / 2.316m; (3) in infertile patients with different factors, ovulation induction cycle could increase the live birth rate of patients with tubal and pelvic factors. Conclusion: ovulation promotion cycle can improve the clinical pregnancy and live birth rate of patients with pelvic and fallopian tube factors.
【作者单位】：解放军第一七四医院生殖医学中心;
【分类号】：R711.6
【正文快照】： 宫腔内人工授精(intrauterine insemination,IUI)是指在排卵期将处理后的男方精液注入女性宫腔内,是一项常用的治疗不孕症的技术,方法简单,创伤性小,临床应用广泛。1984年Sher等首次应用控制性促排卵后IUI治疗各种原因引起的难治性不孕症[1],经一个周期的治疗,妊娠率达35%。自

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