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目的比较不同病因、年龄组促排卵周期和自然周期人工授精临床妊娠率和流产率差异,分析促排卵对宫腔内人工授精周期结局的影响。方法回顾性分析我院生殖科2006年1月～2011年12月1224个人工授精周期,根据病因、年龄、HCG日大卵泡数分组,比较各组内促排卵周期与自然周期临床妊娠率和流产率的差异。结果①促排卵周期人工授精妊娠率为17.7%,自然周期妊娠率为11.3%(P<0.05),有统计学差异;两组流产率无差异(15.4%,25.3%,P>0.05)。②促排卵周期中,氯米芬和HMG周期妊娠率分别为16.4%,18.2%;流产率分别为:25.0%,14%,差异均无统计学意义(P>0.05)。③年龄>35岁与<35岁比较妊娠率无差异(13.2%,13.4%,P>0.05),流产率显著增加(35%,15.1%,P<0.00)。年龄<35岁,OI周期妊娠率明显高于自然周期(17.6%,9.7%,P<0.05)。OI周期和自然周期流产率在不同年龄组均无差异。④促排卵周期中,排卵障碍组、不明原因不孕组的妊娠率(30.7%,28.1%)高于自然周期(21.7%,8.3%),差异有统计学意义。宫颈因素、男性因素、双方因素、子宫内膜异位症不孕患者,促排卵治疗妊娠率(11.3%,12.5%,9.8%,17.1%)与自然周期(11.3%,11.2%,8.3%,9.5%)相似,差异无显著意义。心理障碍组自然周期妊娠率(47.4%)高于促排卵周期(33.3%)(P<0.05)。⑤促排卵周期,HCG日单卵泡组妊娠率为16.7%,多卵泡组19.0%,差异无显著性(P>0.05)。结论促排卵周期妊娠率高于自然周期,不增加流产率。以不明原因不孕及排卵障碍行IUI治疗者,促排卵治疗可增加妊娠率,对于男性因素、子宫内膜异位症或年龄大于35岁患者促排卵不增加妊娠率。
Objective To compare the clinical pregnancy rates and abortion rates of ovulation cycles and natural cycles of artificial insemination in different etiology, age groups and to analyze the effect of ovulation induction on the intrauterine insemination period outcomes. Methods Retrospective analysis of reproductive department in our hospital from January 2006 to December 2011 1224 artificial insemination period, according to the cause, age, HCG large follicles were divided into groups to compare the ovulation cycles and natural cycles of clinical pregnancy rates and abortion Rate difference. Results ① The pregnancy rate of artificial insemination during ovulation induction period was 17.7%, and the natural pregnancy rate was 11.3% (P <0.05). There was no significant difference between the two groups (15.4%, 25.3%, P> 0.05). ② In ovulation induction cycles, the pregnancy rates of clomiphene and HMG were 16.4% and 18.2% respectively; the abortion rates were 25.0% and 14% respectively, with no significant difference (P> 0.05). (3) There was no difference in pregnancy rates between 35 years old and 35 years old (13.2%, 13.4%, P> 0.05). Abortion rate increased significantly (35%, 15.1%, P <0.00). The age of 35 years old, OI cycle pregnancy rate was significantly higher than the natural cycle (17.6%, 9.7%, P <0.05). OI cycle and spontaneous abortion rate in different age groups were not different. ④ In ovulation cycle, the pregnancy rate (30.7%, 28.1%) in ovulation disorder group and unexplained infertility group was higher than that in natural cycle (21.7%, 8.3%), the difference was statistically significant. Cervical factors, male factors, both factors, infertility patients with endometriosis, ovulation induction pregnancy rates (11.3%, 12.5%, 9.8%, 17.1%) and natural cycles (11.3%, 11.2%, 8.3% 9.5%) similar, the difference was not significant. Natural cycle pregnancy rate (47.4%) was higher than that of ovulation induction period (33.3%) in psychological disorder group (P <0.05). ⑤ ovulation cycle, HCG single follicles group pregnancy rate was 16.7%, 19.0% in the multi-follicle group, the difference was not significant (P> 0.05). Conclusion Ovulation cycle pregnancy rate higher than the natural cycle, does not increase the abortion rate. With unexplained infertility and ovulation disorders IUI treatment, ovulation induction treatment can increase the pregnancy rate, for male factors, endometriosis or patients older than 35 years of ovulation does not increase the pregnancy rate.