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供精人工授精结局分析及临床应用价值 被引量:9

Analysis of the Parameters Affecting the Pregnancy Rate and Clinical Value of Artificial Insemination by Donor
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摘要 目的:探讨供精人工授精(AID)成功的影响因素及临床应用价值。方法:回顾性分析在本中心实施AID的2467对不孕夫妇共5470个周期的临床资料,分析影响AID临床妊娠率的相关因素及妊娠结局。结果:①年龄〈35岁和≥35岁的临床妊娠率分别为21.49%和12.27%,差异有统计学意义(P〈O.05);②不孕年限≤5年和〉5年者比较,妊娠率有统计学差异(22.09%vs16.45%,P〈0.05);③自然周期和控制性促排卵周期的临床妊娠率分别为21.92%和17.46%,差异有统计学意义(P〈O.05);④不同授精方式宫颈内授精(ICI)、宫腔内授精(IuI)及ICI/IUI组的临床妊娠率分别为20.61%、16.52%和18.56%,差异无统计学意义(P〉O.05);⑤每周期授精次数对AID的妊娠率有显著影响,1次和2次授精的成功率分别为10.64%和21.26%(P〈0.05);⑥注入前向运动精子总数40。60×106和〉60×106的妊娠率有统计学差异(19.32%VS26.07%,P〈0.05);⑦第1、第2、第3、第4周期的累计妊娠率分别为20.02%、33.40%、41.06%、43.70%,随着授精次数的增加,累计妊娠率显著升高(火0.05);⑧1110例妊娠者中33例(11.98%)流产,13例(1.17%)发生宫外孕,多胎率为3.15%,出生缺陷发生率为0.67%。结论:①在AID治疗中女方年龄、不孕年限、治疗方案、授精次数及注入前向运动精子总数均是影响成功妊娠的相关因素;②AID技术安全有效,患者至少应进行3~4个周期的AID治疗,未成功者应及时求助于试管婴儿等其他辅助生殖技术。 Objective: To analyze the parameters affecting the pregnancy rate (PR) and clinical value in artificial insemination by donor (AID). Methods: Retrospective analysis of 2 467 infertile couples with 5 470 treatment cycles were performed. The parameters affecting the pregnancy rate and pregnancy outcome were analyzed. Results: l) The PR in female age 〈35 years and ~〉 35 years were 21.49% and 12.27%, there was a significantly statistical difference (P〈0.05). 2) The PR in infertility duration between ≤5 years and 〉5 years were 22.09% and 16.45% (P〈0.05). 3) There was a statistical difference in PR between natural and stimulation cycles (21.92% vs 17.46%, P〈0.05). 4) There were no statistical differences in PR using ICI, IUI or ICI/IUI (P〉0.05). 5) The frequency of insemination per cycle had an important influence in PR, the PR of twice insemination per cycle (21.26%) was significantly higher than that of once insemination group (10.64%) (P〈0.05). 6) The PR in the total number of progressively motile sperm 40-59 × 106 group and ≥60 × 106 group were 19.32% and 26.07% (P〈0.05). 7) The cumulative pregnancy rate had a significantly increased tendency in 1,2,3, 4 cycles (P〈0.05). 8) The abortion rate, the ectopic pregnancy rate, the multiple pregnancy rate and the birth defect rate were 11.98%, 1.17%, 3.15% and 0.67%, respectively. Conclusion: l) The female age, infertifity duration, treatment prescription, frequency of insemination per cycle and the total number of progressively motile sperm were related factors in AID; 2) AID was a safe assisted reproductive technique, IVF/ICSI can be resorted to immediately after AID has failed three or four times.
作者 宋革 郑炜炜 钟小英 舒小妹 姜荣华 伍圆圆 李秋华 曾丽萍 Ge SONG, Wei-wei ZHENG, Xiao-ying ZHONG, Xiao-mei SHU Rong-hua JIANG, Yuan-yuan WU, Qiu-hua LI, Li-ping ZENG (The Reproductive Centre of the Family Planning Special Hospital of Guangdong Province, Guangzhou, 510060)
出处 《生殖与避孕》 CAS CSCD 2014年第5期410-414,420共6页 Reproduction and Contraception
基金 本研究为广东省人口和计划生育委员会重点科研项目(2008001)
关键词 无精子症 供精人工授精(AID) 临床妊娠率 累计妊娠率 azoospermia artificial insemination by donor (AID) clinical pregnancy rate cumulative pregnancy rate
作者简介 通讯作者:宋革;Tel:+86—20—87616711;Fax:+86—20—87777331;E-mail:songgepp@126.com
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