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目的:探讨授精时机和次数对夫精宫腔内人工授精(IUI)妊娠结局的影响。方法:选择在本中心行IUI的195例不孕患者共379个IUI周期,随机分成4组:于h CG注射后24 h行IUI,即排卵前单次授精组(A组,n=93)和排卵后单次授精组(B组,n=102);于h CG注射后48 h再次行IUI,即排卵前、后各行1次IUI的双次授精组(C组,n=84)和均在排卵前行IUI的双次授精组(D组,n=100)。分析精液处理后活动精子总数(processed total motile sperm,PTMS)、授精时机和次数与各组IUI周期妊娠率之间的关系。结果:当PTMS<5×106时,仅B组妊娠1例,其余各组未妊娠;当PTMS≥5×106时,各组妊娠率均有显著提高,B组周期妊娠率(32.22%)显著高于A组(14.12%)、C组(20.00%)和D组(17.39%)(P<0.05),A组、C组和D组之间周期妊娠率无统计学差异(P>0.05)。结论:PTMS≥5×106是IUI获得理想妊娠率的首要条件,h CG注射后24 h排卵后行单次授精可获得理想周期妊娠率,若此时仍未排卵患者行双次授精亦不能显著提高周期妊娠率。
Objective: To investigate the effect of timing and number of insemination on intrauterine insemination (IUI) pregnancy outcome. METHODS: A total of 195 infertile patients with IUI in our center were enrolled in this study. A total of 379 IUI cycles were randomly divided into 4 groups: IUI at 24 h after h CG injection, ie single insemination group (group A, n = 93) (Group B, n = 102). IUI was again performed at 48 h after h CG injection, that is, double insemination (group C, n = 84) Both pre-ovulation IUI double insemination groups (D group, n = 100). The relationship between semen processing total motile sperm (PTMS), timing and number of insemination and pregnancy rate of IUI in each group was analyzed. Results: When PTMS was less than 5 × 106, only one pregnancy in group B and no pregnancy in other groups. Pregnancy rates in all groups were significantly increased when PTMS≥5 × 106, and the pregnancy rate in group B was significantly higher than that in group B (32.22%) (P <0.05). There was no significant difference in the pregnancy rate among groups A, C and D (P> 0.05), but higher than that in group A (14.12%), C (20.00%) and D (17.39% . CONCLUSION: PTMS≥5 × 106 is the first condition for IUI to achieve ideal pregnancy rate. Single embryo pregnancy rate can be obtained by single insemination 24 h after h CG injection, and double fertilization is not significant at this time Improve cycle pregnancy rate.