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目的探讨部分男性不育相关因素对精子质量和夫精宫腔内人工授精(AIH-IUI)妊娠率、流产率的影响。方法回顾性分析2006年1月至2009年6月在我院生殖医学中心接受治疗的153对不育夫妇,250个IUI周期,分别对男性不育年龄、不育类型和年限、体重指数(BMI)、吸烟情况、精液优化后活动精子(a+b)计数进行分组统计少弱精子症接受IUI周期所占比率、周期妊娠率(PPR)、流产率,比较分析正常精子质量和少弱精子症IUI治疗PPR和流产率。结果总治疗周期250个,妊娠数35,PPR为13.6%,流产数16,流产率45.71%。治疗前检查精子质量位于正常范围周期97个,妊娠数13,PPR为13.4%,流产数3,流产率23.08%;少弱精子症夫妇97对,治疗周期153个,妊娠数21,PPR为13.73%,流产数13,流产率61.90%。男性相关因素:年龄、体重指数、不育年限、每日吸烟量对精液质量有不良影响,相同因素PPR正常精液质量组高于少弱精症组,流产率明显低于后者,存在统计学差异(P<0.05)。精液优化前后对PPR和流产率均有影响,优化后获得妊娠的最小活动精子(a+b)计数为4×106/ml。结论男性年龄、体重指数、不育时间、每日吸烟量影响精子质量和IUI结局。高龄、高体重指数、吸烟的少弱精子症男性对IUI结局有不良影响。选择合适的精液优化方法最大限度回收活动精子,可以获得良好妊娠结局。
Objective To investigate the effects of some male infertility factors on sperm quality and pregnancy rate and miscarriage rate in intrauterine insemination (AIH-IUI). Methods A retrospective analysis of 153 pairs of infertile couples and 250 IUI cycles treated in the Reproductive Medicine Center of our hospital from January 2006 to June 2009 were conducted. The male infertility age, infertility type and length of life, body mass index (BMI ), Smoking status, active sperm (a + b) counts after sperm motility were divided into groups. Weak semen received IUI cycles, PPR, miscarriage rate, comparative analysis of normal sperm quality and oligoasthenospermia IUI treats PPR and abortion rates. Results The total treatment period was 250, pregnancy 35, PPR 13.6%, abortion number 16, abortion rate 45.71%. Pretreatment examination sperm quality is located in the normal range of 97 cycles, the number of pregnancies 13, PPR was 13.4%, the abortion number 3, the abortion rate was 23.08%; 97 fewer azoospermia couples, the treatment cycle 153, the number of pregnancies 21, PPR 13.73 %, Abortion number 13, abortion rate 61.90%. Male-related factors: age, body mass index, duration of infertility, daily amount of cigarettes on the quality of semen have adverse effects, the same factors PPR normal sperm quality group than in the group of less severe asthma, the abortion rate was significantly lower than the existence of statistics Difference (P <0.05). Before and after sperm optimization had effects on both PPR and miscarriage rates, and the minimum motile sperm (a + b) count for pregnancy was 4 × 10 6 / ml. Conclusion Male age, BMI, duration of infertility and daily smoking intake affect sperm quality and IUI outcome. Older, high body mass index, smokers with oligoasthenospermic men have an adverse effect on IUI outcomes. Choose the right sperm optimization method to maximize the recovery of active sperm, you can get a good pregnancy outcome.