摘要
目的:分析影响高龄不孕妇女IUI获临床妊娠的不利因素,并找出高龄妇女转变助孕方式的时机。方法回顾佛山市妇幼保健院生殖中心自2008年1月~2012年1月行IUI助孕325对夫妇550个IUI周期的资料,统计分析女方不同年龄段、不孕类型、不孕年限、接受IUI的周期数、3种促排卵周期和自然周期对高龄妇女IUI临床妊娠率的影响。结果≧40岁组临床妊娠率明显低于35~36岁组(=0.028);≧5年组临床妊娠率明显低于1~2年组(=0.037);HMG/丽申宝促排卵周期临床妊娠率明显高于自然周期和CC/CC+HMG周期(P值分别为0.012、0.020),40岁及以上患者使用CC/CC+HMG促排卵共21周期,未见有临床妊娠,而HMG/丽申宝促排卵周期临床妊娠率为9.0%(6/67);≧40岁且不孕年限≧5年妇女行IUI助孕共有33周期,仅有1例获临床妊娠,妊娠率为3.0%(1/33);≧40岁妇女接受第3次及以上助孕周期共15周期,未有获临床妊娠者。结论不孕年限及促排卵方案是影响高龄妇女IUI获临床妊娠的重要因素,40岁以上患者通过IUI的获临床妊娠率机会低下。高龄妇女行IUI建议使用Gn促排卵,避免使用CC,进行2个周期的IUI助孕治疗后可考虑转其他助孕方式,特别是对不孕年限≧5年或40岁及以上妇女;不孕年限达5年或者以上,并且患者≧40岁,则建议直接行IVF/ICSI助孕。
Objective To investigate and analyze factors that influence pregnancy rate of intrauterine insemination(IUI)with husband sperm in women of advancing age,to find the best timing to change assisted reproductive technology.Methods The clinical data of 325 infertile couples undergoing 550 IUI were analyzed in Center,Foshan Maternal&Children Health Hospital.Relationships between pregnancy rate and maternal age,infertile types,infertile time,natural cycle and 3 types of ovulation induction cycle were investigated.Results The clinical pregnancy rate was significantly lower in women aged 40 years or more than 35~36 years(=0.028).The clinical pregnancy rate was significantly lower in patients with duration of infertile≥5 years than 1~2 years(=0.037).The clinical pregnancy rate was higher in ovulation induction cycles with menotrophin/urofol itropin than with CC/CC+HMG and natural cycles(=0.012,0.020).There were 21 cycles aged use CC/CC+HMG for ovulation induction in 40 years and older,no one got clinical pregnancy,but clinical pregnancy rate in menotrophin/urofol itropin cycles was 9.0%(6/67);there were 33 IUI cycles in whom≥40 years and duration of infertility≥5 years,only one case got clinical pregnancy,the pregnancy rate was 3.03%(1/33);A total of 15 cycles women whom≥40-year-old undergoing IUI 3rd and over time,no one got clinical pregnancy.Conclusion In IUI cycles,duration of infertile,ovulation induction cycle would af ect pregnancy rate in women in advancing age,pregnancy rate in IUI cycles were low in women aged 40 years or more.Using Gn for ovulation was recommended to use in older women,not CC.After two cycles of IUI trying,should change another assisted reproductive,especial y for whom duration of infertility≥5 years or 40 years or more.It is recommended IVF/ICSI treatment for whom durationg of infertility≥5 years and age≥40 years old.
作者
陈孟循
马文敏
朱莉
吴雅琴
司徒艳球
谭晓慧
CHEN Meng-xun;MA Wen-min;ZHU Li;WU Ya-qin;SITU Yan-qiu;TAN Xiao-hui(Foshan City Maternal and Child Health Hospital,Foshan 528000,Guangdong,China)
关键词
人工授精
年龄
促排卵
不利影响因素
Intrauterine insemination
Pregnancy rate
Age
Negative influence
