影响宫腔内人工授精妊娠率的临床及精液因素分析

doi:10.3877/cma.j.issn.1673-5250.2013.04.011

中华妇幼临床医学杂志(电子版) ›› 2013, Vol. 09 ›› Issue (04) : 477 -480. doi: 10.3877/cma.j.issn.1673-5250.2013.04.011

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论著

影响宫腔内人工授精妊娠率的临床及精液因素分析

速存梅¹^,^*^,^*(

), 王珏¹, 苏兰¹, 廖戎¹, 潘汝能¹, 赵树华², 焦云萍¹, 刘清梅¹

^1. 650021　昆明，云南省人口和计划生育科学技术研究所
^2. 云南省少数民族优生重点实验室

收稿日期:2013-04-04 修回日期:2013-07-10 出版日期:2013-08-01
通信作者: 速存梅

Analysis of Clinical and Spermatic Factors on Pregnancy Rate of Intrauterine Insemination

Cun-mei SU¹(), Jue WANG¹, Lan SU¹, Rong LIAO¹, Ru-neng PAN¹, Shu-hua ZHAO², Yun-ping JIAO¹, Qing-mei LIU¹

^1. Yunnan Population and Family Planning Reaearch Institute, Kunming 650021, Yunnan Province, China

Received:2013-04-04 Revised:2013-07-10 Published:2013-08-01
Corresponding author: Cun-mei SU
About author:
(Corresponding author: SU Cun-mei, Email: greenca@126.com)

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目的

探讨影响宫腔内人工授精(IUI)的临床及精液因素。

方法

选择2009年1月至2011年9月在云南省人口和计划生育科学技术研究所就诊的213对不孕不育夫妇接受IUI助孕治疗的298个周期的临床病历资料为研究对象(本研究遵循的程序符合云南省人口和计划生育科学技术研究所制定的伦理学标准，得到该委员会批准)。分析女方年龄、不孕年限、原发性或继发性不孕、是否促排卵治疗及处理后精子活动总数(PTMS)与IUI临床妊娠率间的关系。

结果

<30岁，30～34岁和35～39岁间的IUI临床妊娠率比较，差异无统计学意义(χ²＝4.58，P>0.05)，≥40岁的IUI临床妊娠率较另3者明显下降，差异有统计学意义(χ²＝179，P<0.05)；不孕年限≥5年较<2年与3～4年者的IUI临床妊娠率明显下降，3者比较，差异有统计学意义(χ²＝298，P<0.05)。继发性不孕的IUI临床妊娠率高于原发性不孕(χ²＝578，P<0.05)。PTMS<5×10⁶/mL与PTMS为(5～10)×10⁶/mL和PTMS>10×10⁶/mL的IUI临床妊娠率比较，差异有统计学意义(χ²＝596，P<0.05)。

结论

在IUI中，女方年龄、不孕年限、原发性和继发性不孕、是否促排卵治疗和PTMS均可影响IUI临床妊娠率。

关键词: 处理后精子活动总数, 人工授精, 妊娠率

Objective

To evaluate the effect-relative factors on pregnancy rate after intrauterine insemination (IUI) by analyzing the clinical data of patients receiving IUI with husband sperm.

Methods

Clinical data of 213 infertile couples who received IUI in Yunnan Population and Family Planning Research Institute from January 2009 to September 2011 were selected, and 298 cycles were included. This study followed the ethical standards which formulated by Yunnan Population and Family Planning Research Institute, approved by the committee. The relationship between clinical factors, including maternal age, infertile time, infertile type, ovulation induction protocol, processed total motile sperm count(PTMS) and pregnancy rate were analyzed.

Results

The pregnancy rate in the group of <30, 30-34 and 35-39 were not significant (χ²=4.58, P>0.05). The pregnancy rate of the patients ≥40 years old decreased significantly (χ²=179, P<0.05). The pregnancy rate of the patients with infertile time≥5 years was more higher than that of infertile time <2 years and 3-4 years (χ²=298, P<0.05). The pregnancy rate of the patients with secondary infertility was significantly higher than that of the patients with primary infertility (χ²=578, P<0.05). The pregnancy rate in the groups of PTMS <5×10⁶/mL, (5-10)×10⁶/mL, >10×10⁶/mL were significantly difference (χ²=596, P<0.05).

Conclusions

In the course of IUI with husband sperm, female age, infertile time, primary or secondary infertility, ovulation induction protocol and PTMS could affect pregnancy rate.

Key words: processed total motile sperm count, intrauterine insemination, pregnancy rate

表1 女方年龄对IUI临床妊娠率的影响

Table 1 The influence of female age on IUI pregnancy rates

年龄(岁)	n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)
<30	33	63	11	17.46
30～34	102	126	19	15.08
35～39	65	91	11	12.08
≥40	13	18	1	5.56

表1 女方年龄对IUI临床妊娠率的影响

Table 1 The influence of female age on IUI pregnancy rates

年龄(岁)	n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)
<30	33	63	11	17.46
30～34	102	126	19	15.08
35～39	65	91	11	12.08
≥40	13	18	1	5.56

表2 不孕年限、类型对IUI临床妊娠率的影响

Table 2 The influence of infertile time and type on IUI pregnancy rates

项目		n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)	χ²	P
不孕类型		?	?	?	?	?	?
?	原发性不孕	115	166	20	12.05	578	0.00
?	继发性不孕	98	132	22	16.67	?	?
不孕年限(年)		?	?	?	?	?	?
?	<2	55	79	14	17.72	298	0.00
?	2～4	94	135	20	14.81	?	?
?	≥5	64	84	8	9.52	?	?

表2 不孕年限、类型对IUI临床妊娠率的影响

Table 2 The influence of infertile time and type on IUI pregnancy rates

项目		n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)	χ²	P
不孕类型		?	?	?	?	?	?
?	原发性不孕	115	166	20	12.05	578	0.00
?	继发性不孕	98	132	22	16.67	?	?
不孕年限(年)		?	?	?	?	?	?
?	<2	55	79	14	17.72	298	0.00
?	2～4	94	135	20	14.81	?	?
?	≥5	64	84	8	9.52	?	?

表3 自然周期与促排卵周期的IUI临床妊娠率比较

Table 3 Comparison between the pregnancy rates of natural cycle and stimulation cycle

方案	n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)	χ²	P
自然周期＋hCG	128	188	24	12.77	5.54	0.136
HMG＋hCG	85	110	18	16.36	?	?

表3 自然周期与促排卵周期的IUI临床妊娠率比较

Table 3 Comparison between the pregnancy rates of natural cycle and stimulation cycle

方案	n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)	χ²	P
自然周期＋hCG	128	188	24	12.77	5.54	0.136
HMG＋hCG	85	110	18	16.36	?	?

表4 PTMS与IUI临床妊娠率的关系

Table 4 The relationship between processed total motile sperm count and IUI pregnancy rates

PTMS(×10⁶/mL)	女方年龄(±s，岁)	不孕年限(±s，年)	治疗周期数(个)	临床妊娠数(个)	周期妊娠率(%)
<5	32.5±4.4	2.9±1.5	56	3	5.36
5～10	34.6±3.8	3.5±2.1	133	22	16.54
>10	31.9±2.4	3.7±2.4	109	17	16.00

表4 PTMS与IUI临床妊娠率的关系

Table 4 The relationship between processed total motile sperm count and IUI pregnancy rates

PTMS(×10⁶/mL)	女方年龄(±s，岁)	不孕年限(±s，年)	治疗周期数(个)	临床妊娠数(个)	周期妊娠率(%)
<5	32.5±4.4	2.9±1.5	56	3	5.36
5～10	34.6±3.8	3.5±2.1	133	22	16.54
>10	31.9±2.4	3.7±2.4	109	17	16.00

1	ESHRE Capri Workshop Group. Intrauterine insemination[J]. Hum Reprod Update, 2009, 15(3): 265-277.
2	Wang B, Hu YL, Sun HX, et al. Investigation of correlative factors affecting successful intrauterine insemination[J]. Chin J Androl, 2004, 10(7): 526-529.
3	Merviel P, Heraud MH, Grenier N, et al. Predictive factors for pregnancy after intrauterine insemination (IUI): An analysis of 1038 cycles and a review of the literature[J]. Fertil Steril, 2010, 93(1): 79-88.
4	Plosker SM, Jacobson WA, Mao P. Predicting and optimizing success in an intrauterine insemination program[J]. Hum Reprod, 1994, 9(11): 2014-2021.
5	Iberico G, Vioque J, Ariza N, et al. Analysis of factors influencing pregnancy rates in homologous intrauterine insemination[J]. Fertil Steril, 2004, 81(5): 1308-1313.
6	Zadehmodarres S, Oladi B, Saeedi S, et al. Intrauterine insemination with husband semen: An evaluation of pregnancy rate and factors affecting outcome[J]. J Assist Reprod Genet, 2009, 26(1): 7-11.
7	Bensdorp AJ, Cohlen BJ, Heineman MJ, et al. Intra-uterine insemination for male subfertility[J]. Cochrane Database Syst Rev, 2007, 17(4): CD000360.
8	Ferrara I, Balet R, Grudzinskas JG. Intrauterine insemination with frozen donor sperm pregnancy outcome in relation to age and ovarian stimulation regime[J]. Hum Reprod, 2002, 17(9): 2320-2324.
9	Zhu WB, Fan LQ, Zheng YR, et al. Effect of different time of insemination and number of motile sperm on IUI pregnancy rate[J]. Chin J Androl, 2003, 17(2)：110-112.
10	Lu SM, Zhao LX, Chen ZJ, et al. The effect of sperm parameters on pregnancy outcome after intrauterinein semination[J]. Chin J Androl, 2006, 20(1): 32-34.
11	Cheng J, Zhang LJ, Su H. Analysis of the male factors impacting to pregnancy rate of intrauterine insemination with husband's semen[J]. Chin J Birth Health Hered, 2011, 19(3): 99-102.
12	Badawy A, Elnashar A, Eltotongy M. Effect of sperm morphology and number on success of intrauterine insemination[J]. Fertil Steril, 2009, 91(3): 777-781.

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Analysis of Clinical and Spermatic Factors on Pregnancy Rate of Intrauterine Insemination

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Analysis of Clinical and Spermatic Factors on Pregnancy Rate of Intrauterine Insemination