摘要
目的探讨与宫腔内人工授精(intrauterine insemination,IUI)的活产率相关的临床影响因素。方法采用回顾性队列研究,收集2015年1月至2018年12月期间于北京大学第三医院妇产科生殖医学中心行IUI治疗的9077例患者共15740个周期的临床资料。分析年龄、不孕年限、不孕类型、不孕因素、周期方案、周期次数、授精时机、处理后前向运动精子浓度、排卵数等方面对活产率的影响。分析促排卵周期中不同排卵数的活产率的差异。结果共纳入15740个IUI周期,临床妊娠率为11.3%(1784/15740),活产率为8.5%(1339/15740)。在单因素分析中:年龄因素中<30岁活产率[10.62%(462/4349)]与0~35岁及>35岁的活产率[8.27%(748/9048)、5.51%(129/2343)]差异有统计学意义(P<0.001);不孕因素中女性因素在IUI治疗后活产率[11.51%(357/3101)],与男性因素、双方因素及不明原因的活产率[8.14%(337/4142)、8.09%(216/2670)、7.36%(429/5829)]差异有统计学意义(P<0.001);周期方案中促排卵周期活产率[10.19%(850/8343)]与自然周期[6.61%(489/7397)]活产率差异有统计学意义(P<0.001);排卵个数组中排卵数≥3时活产率[11.80%(19/161)],与排卵数为1及2的活产率[8.31%(1233/14837)、11.73%(87/742)]差异有统计学意义(P<0.001)。在不同的不孕类型、授精时机、处理后前向运动精子浓度、不孕年限、授精次数等方面差异均无统计学意义(均P>0.05)。多因素分析显示:年龄(OR=0.766,95%CI=0.700~0.838)、不孕因素(男方因素OR=0.762,95%CI=0.649~0.893;双方因素OR=0.759,95%CI=0.634~0.909;不明原因OR=0.708,95%CI=0.608~0.824)、周期方案(OR=1.421,95%CI=1.260~1.604)、排卵数(OR=1.206,95%CI=1.018~1.430)是IUI活产率的独立影响因素。促排卵周期中不同排卵数的活产率差异比较,排卵数为2的活产率[13.45%(83/617)]高于排卵数为1及3以上的活产率[9.89%(750/7582)、11.81%(17/144),P=0.016]。结论女方年龄、不孕因素、周期方案、排卵数是IUI活产�
Objective To explore the clinical factors related to the live birth rate of intrauterine insemination(IUI).Methods A retrospective cohort study was conducted in 9077 patients treated with IUI for 15740 cycles in Center of Reproductive Medicine,Department of Obstetrics and Gynecology,Peking University Third Hospital from January 2015 to December 2018.The effects of female age,duration of infertility,types of infertility,factors of infertility,protocols and times of cycles,time of insemination,forward motile sperm concentration after treatment and the number of broken eggs on the live birth rate were analyzed.The difference of live birth rate of different number of broken eggs in ovulation induction cycle was analyzed.Results A total of 1784 clinical pregnancy cycles were obtained in 15740 IUI cycles,with a clinical pregnancy rate of 11.3%(1784/15740)and a live birth rate of 8.5%(1339/15740).In univariate analysis,among the age factors,the live birth rate of different aged patients was significantly different[<30 years old 10.62%(462/4349),30-35 years old 8.27%(748/9048),>35 years old 5.51%(129/2343),P<0.001].Among the factors of infertility,the live birth rate of the female factors[11.51%(357/3101)]was significantly different from the male factors[8.14%(337/4142)],the bilateral factors[8.09%(216/2670)]and the unexplained factors[7.36%(429/5829)]after IUI treatment(P<0.001).The live birth rate in the ovulation induction cycle[10.19%(850/8343)]was different from that in the natural cycle[6.61%(489/7397),P<0.001].In the No.of oocytes ovulated group,the live birth rate when the number of ovulation was≥3[11.80%(19/161)]was significantly different from that in the groups with ovulation number of 1 and 2[8.31%(1233/14837),11.73%(87/742),P<0.001].There were no significant differences in different types of infertility,time of insemination,forward motile sperm concentration after treatment,duration of infertility and time of insemination.Multivariate analysis showed that female age(OR=0.766,95%CI=0.700-0.838),factors of i
作者
雷淼
黄铄
罗莉
李蓉
刘平
Lei Miao;Huang Shuo;Luo Li;Li Rong;Liu Ping(Center of Reproductive Medicine,Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China;Center of Reproductive Medicine,Department of Obstetrics and Gynecology,Liupanshui Maternal and Child Health Hospital,Liupanshui 553000,China)
出处
《中华生殖与避孕杂志》
CAS
CSCD
北大核心
2022年第5期476-483,共8页
Chinese Journal of Reproduction and Contraception
基金
国家重点研发计划(2018YFC1002106)。
关键词
授精
人工(丈夫供体)
不育
女性
活产率
Insemination,artificial,homologous
Infertility,female
Live birth rate
