夫精人工授精临床妊娠率的影响因素分析-东南大学学报医学版

夫精人工授精临床妊娠率的影响因素分析

单位：南京医科大学附属无锡人民医院生殖医学科, 江苏无锡 214021

分类号：R711.6

出版年·卷·期（页码）：2022·41·第五期（623-628）

摘要：

目的：回顾性分析宫腔内夫精人工授精（AIH）患者的临床资料，评估影响AIH临床妊娠率的因素。方法：收集2019年1月至2021年12月在无锡市人民医院生殖医学中心接受AIH治疗的138对夫妇（248个周期）的临床资料：不孕症类型、手术史、女方年龄、男方年龄、不孕年限、体重指数、子宫内膜厚度、优势卵泡数及大小、卵泡直径、扳机时雌激素及黄体生成素的水平、扳机方案及治疗周期数等，采用广义估计方程分析AIH临床妊娠的影响因素。结果：多因素广义估计方程模型显示，不孕年限≥2年的患者与<2年的患者相比，人工授精临床妊娠的成功率降低69.7%（95%CI为0.129~0.713，P<0.01）。未发现其他因素与AIH临床妊娠的统计学关联（P>0.05）。结论：不孕症患者应尽早就医治疗，不孕年限是降低AIH临床妊娠率的危险因素。

Objective: To retrospectively analyze the clinical data of patients with intrauterine artificial insemination husband sperm(AIH), and to evaluate the influencing factors of clinical pregnancy rate of AIH. Methods: The clinical data of 138 couples (248 cycles) who received AIH treatment in our hospital from January 2019 to December 2021 were collected according to the type of infertility, operation history, age of the woman, age of the man, years of infertility, body mass index, endometrial thickness, number and size of dominant follicles, follicle diameter, estrogen and luteinizing hormone levels during trigger, trigger scheme and number of treatment cycles, the generalized estimation equation was used for analysis. Results: The multivariable generalized estimation equation model showed that the success rate of clinical pregnancy of artificial insemination decreased by 69.7% (95%CI: 0.129-0.713, P<0.01) in patients with infertility of 2 years or more compared with patients with infertility of less than 2 years. Other factors were not significant. Conclusion: Infertility patients should seek medical treatment as soon as possible. The number of years of infertility is a risk factor affecting the clinical pregnancy rate of AIH.

参考文献：

[1] BAHADUR G, HOMBURG R.Growing body of evidence supports intrauterine insemination as first line treatment and rejects unfounded concerns about its efficacy, risks and cost effectiveness[J].JBRA Assist Reprod, 2019, 23:62-67.
[2] WANG R, DANHOF N A, TJON-KON-FAT R I, et al.Interventions for unexplained infertility:a systematic review and network meta-analysis[J].Cochrane Database Syst Rev, 2019, 9:Cd012692.
[3] RODRIGUEZ-PURATA J, LATRE L, BALLESTER M, et al.Clinical success of IUI cycles with donor sperm is not affected by total inseminated volume:a RCT[J].Hum Reprod Open, 2018, 2018:hoy002.
[4] THIJSSEN A, CREEMERS A, VAN DER ELST W, et al.Predictive value of different covariates influencing pregnancy rate following intrauterine insemination with homologous semen:a prospective cohort study[J].Reprod Biomed Online, 2017, 34:463-472.
[5] ZEGERS-HOCHSCHILD F, ADAMSON G D, DE MOUZON J, et al.International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009[J].Fertil Steril, 2009, 92:1520-1524.
[6] GHAFFARI F, SADATMAHALLEH S J, AKHOOND M R, et al.Evaluating the effective factors in pregnancy after intrauterine insemination:a retrospective study[J].Int J Fertil Steril, 2015, 9:300-308.
[7] ASHRAFI M, RASHIDI M, GHASEMI A, et al.The role of infertility etiology in success rate of intrauterine insemination cycles:an evaluation of predictive factors for pregnancy rate[J].Int J Fertil Steril, 2013, 7:100-107.
[8] SICCHIERI F, SILVA A B, SILVA A, et al.Prognostic factors in intrauterine insemination cycles[J].JBRA Assist Reprod, 2018, 22:2-7.
[9] WISER A, SHALOM-PAZ E, REINBLATT S L, et al.Ovarian stimulation and intrauterine insemination in women aged 40 years or more[J].Reprod Biomed Online, 2012, 24:170-173.
[10] VARGAS-TOMINAGA L, ALARCÓN F, VARGAS A, et al.Associated factors to pregnancy in intrauterine insemination[J].JBRA Assist Reprod, 2020, 24:66-69.
[11] MERVIEL P, HERAUD M H, 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, 93:79-88.
[12] BARROS DELGADILLO J C, ROJAS RUIZ J C, MOLINA MUNGUÍA A C, et al.Prognostic factors of pregnancy in intrauterine insemination[J].Ginecol Obstet Mex, 2006, 74:611-625.
[13] FARHI J, ORVIETO R, GAVISH O, et al.The association between follicular size on human chorionic gonadotropin day and pregnancy rate in clomiphene citrate treated polycystic ovary syndrome patients[J].Gynecol Endocrinol, 2010, 26:546-548.
[14] DINELLI L, COURBIōRE B, ACHARD V, et al.Prognosis factors of pregnancy after intrauterine insemination with the husband's sperm:conclusions of an analysis of 2, 019 cycles[J].Fertil Steril, 2014, 101:994-1000.
[15] WOLFF E F, VAHIDI N, ALFORD C, et al.Influences on endometrial development during intrauterine insemination:clinical experience of 2, 929 patients with unexplained infertility[J].Fertil Steril, 2013, 100:194-199.e1.
[16] WANG J X, WARNES G W, DAVIES M J, et al.Overweight infertile patients have a higher fecundity than normal-weight women undergoing controlled ovarian hyperstimulation with intrauterine insemination[J].Fertil Steril, 2004, 81:1710-1712.
[17] COLLÉE J, MAWET M, TEBACHE L, et al.Polycystic ovarian syndrome and infertility:overview and insights of the putative treatments[J].Gynecol Endocrinol, 2021, 37:869-874.
[18] YAVUZ A, DEMIRCI O, SÖZEN H, et al.Predictive factors influencing pregnancy rates after intrauterine insemination[J].Iran J Reprod Med, 2013, 11:227-234.
[19] OSAIKHUWUOMWAN J, OSEMWENKHA A, IRIBHOGBE O, et al.The effect of female age on the outcome of intrauterine insemination treatment in a public hospital-assisted reproduction technology unit[J].Niger J Clin Pract, 2018, 21:988-992.
[20] SOUTER I, BALTAGI L M, KULETA D, et al.Women, weight, and fertility:the effect of body mass index on the outcome of superovulation/intrauterine insemination cycles[J].Fertil Steril, 2011, 95:1042-1047.
[21] MATHIEU C, ECOCHARD R, BIED V, et al.Cumulative conception rate following intrauterine artificial insemination with husband's spermatozoa:influence of husband's age[J].Hum Reprod, 1995, 10:1090-1097.
[22] FREDERICK J L, DENKER M S, ROJAS A, et al.Is there a role for ovarian stimulation and intra-uterine insemination after age 40?[J].Hum Reprod, 1994, 9:2284-2286.

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