影响宫腔内人工授精妊娠率的临床因素分析

摘要/Abstract

摘要： 目的：分析影响北京大学第三医院生殖医学中心宫腔内人工授精（intra-uterine insemination，IUI）成功率的相关影响因素，旨在更好地指导临床工作。方法：总结自2011年5月至2012年10月5 167个人工授精周期的妊娠率，分析影响其成功率的相关临床因素。单因素分析采用χ²检验，多因素分析采用Logistic回归分析，检验显著性水平α为0.05。结果：临床妊娠661例，周期临床妊娠率为12.8%，人工授精临床妊娠的成功率随着患者年龄及不孕年限的增加而降低，处理后精液密度小于1×10⁶/mL时临床妊娠成功率较低，促排卵周期临床妊娠率高于自然周期，卵泡≥2个较单个卵泡成功率高，第3个周期临床妊娠率高于其他周期，病因为宫颈因素、性功能障碍、多囊卵巢综合征(polycystic ovary syndrome, PCOS)组的临床妊娠成功率高于其他组。结论：年龄、不孕年限、促排卵及卵泡个数、不孕原因是影响本中心妊娠结局的主要因素，处理后精液密度、所行周期数对IUI妊娠率也有一定影响，而人工授精时机及每周期行IUI次数对临床妊娠成功率没有明显影响。

关键词: 授精, 人工, 妊娠率, 危险因素

Abstract: To analyze the factors affecting clinical pregnancy rate of intrauterine insemination in Center of Reproductive Medicine, Peking University Third Hospital, to guide clinical treatment. Methods: In the study, 5 167 intrauterine insemination cycles were retrospectively analyzed from May 2011 to October 2012 in our reproductive center. The data were collected, the single-factor was analyzed with χ² test, and the multifactor was analyzed with Logistic regression with a significant level of 0.05. Results: The cycle clinical pregnancy rate was 12.8%, which decreased with the increase of the female age and infertile duration. The clinical pregnancy rate was low when the sperm density was less than 1×10⁶/mL. In the ovulation group, the clinical pregnancy rate was higher than the natural group. The group with more than 2 dominant follicles had higher clinical pregnancy rate as compared with the single dominant follicle group. The clinical pregnancy rate was the highest in the third cycle but decreased after the fourth cycle. The clinical pregnancy rate was higher in cervical factors, sexual dysfunction, and polycystic ovary than in the group with other reasons. Conclusion: The female age, infertile duration, ovarian stimulation and follicle number, cause of infertility were the main factors affecting clinical pregnancy outcome; the sperm density, and cycle numbers have influence too; the insemination timing, and frequency have little effect.

Key words: Insemination, artificial, Pregnancy rate, Risk factor

徐仰英，王海燕，乔杰，刘平，陈新娜，马彩虹，杜晓果，王晓凤. 影响宫腔内人工授精妊娠率的临床因素分析[J]. 北京大学学报（医学版）, 2013, 45(6): 887-891.

XU Yang-ying, WANG Hai-yan, QIAO Jie, LIU Ping, CHEN Xin-na, MA Cai-hong, DU Xiao-guo, WANG Xiao-feng. Analysis of clinical factors affecting pregnancy rate of intrauterine insemination[J]. Journal of Peking University(Health Sciences), 2013, 45(6): 887-891.

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