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目的观察促排卵药物治疗不孕不育症的效果。方法回顾性分析363对不孕夫妇进行的723个宫腔内人工授精(IUI)周期,根据是否使用促排卵药物及应用促排卵药物的种类分为自然周期组(143对)、枸橼酸氯米芬(CC)组(40对)、尿促性腺激素(HMG)组(126对)及CC+HMG组(54对)促排周期组;各组患者均在排卵前1d、排卵后1d进行一次IUI治疗,比较各组的临床妊娠率、宫外孕率、多胎率及OHSS率。结果促排卵周期总妊娠率为14.5%,略高于自然周期组妊娠率(11.5%),差异无统计学意义(P>0.05)。但是促排卵周期中CC+HMG组的妊娠率22.7%(20/88),明显高于自然周期,差异有统计学意义(P<0.05);CC组的妊娠率为3.0%(2/66)(P<0.05)明显低于自然周期,差异有统计学意义(P<0.05);HMG组妊娠率为14.6%(40/274)与自然周期比较差异无统计学意义(P>0.05);4组宫外孕率、多胎率及卵巢过度刺激综合症的发生率均无明显差异(P>0.05)。结论 IUI治疗中,CC+HMG促排周期妊娠率高于自然周期,是较为理想的治疗方案。
Objective To observe the effect of ovulation induction treatment of infertility. Methods 723 intrauterine insemination (IUI) cycles in 363 pairs of infertile couples were retrospectively analyzed. According to the types of ovulation induction drugs and ovulation induction drugs, they were divided into the natural cycle group (143 pairs), citrate chloride (40 pairs), HMG group (126 pairs) and CC + HMG group (54 pairs). The patients in each group were on the 1st day before ovulation and the first day after ovulation An IUI treatment was performed to compare the clinical pregnancy rate, ectopic pregnancy rate, multiple pregnancy rate and OHSS rate in each group. Results The total pregnancy rate in ovulation cycle was 14.5%, slightly higher than that in natural cycle group (11.5%), the difference was not statistically significant (P> 0.05). However, the rate of pregnancy in CC + HMG group was 22.7% (20/88) in ovulation induction period, which was significantly higher than that in natural period (P <0.05). The pregnancy rate in CC group was 3.0% (2/66) (P <0.05), and the difference was statistically significant (P <0.05). The pregnancy rate in HMG group was 14.6% (40/274), which was not significantly different from the natural cycle (P> 0.05) .4 There was no significant difference in the incidence of ectopic pregnancy, multiple birth rate and ovarian hyperstimulation syndrome (P> 0.05). Conclusion IUI treatment, CC + HMG cycle of pregnancy-induced pregnancy rate is higher than the natural cycle, is an ideal treatment.