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目的探讨促排卵方案、子宫内膜因素、处理后前向运动精子总数和活动率、受精次数对人工授精妊娠率的影响。方法回顾性分析本中心2009-2010年收治的677对病人促排卵方案,子宫内膜类型及厚度,受精次数,将前向运动精子总数分为7组,即A:(4～9)×106,B:(10～12)×106,C:(13～15)×106,D:(16～20)×106,E:(21～25)×106,F:(26～30)×106,G:>30×106,分别比较各组患者年龄、不孕年限、活动率对临床妊娠率的影响。结果 677个周期共获得88例生化妊娠,79例临床妊娠,平均生化妊娠率为13.15%,临床妊娠率为11.81%。促排卵方案以HMG组最好,子宫内膜类型为三线征及内膜厚度大于8mm是妊娠达到10%以上的必要条件。双次人工授精妊娠率(15.27%)明显高于单次(7.57%)。各活动精子数量组妊娠率分别为0、14.37%、11.92%、15.09%、8.33%、20.34%、6.06%,A组临床妊娠率最低,与其余组比较差异有统计学意义,F组活动率和妊娠率最高,与其余组比较差异有统计学意义。结论促排卵方案以HMG组最好;三线征子宫内膜且厚度大于8mm、(26～30)×106精子密度和84%以上的活动率是获得高妊娠率的先决条件;双次人工授精优于单次。
Objective To investigate the effects of ovulation induction program, endometrial factors, the total number of motile sperm and the activity rate and the number of fertilization on the pregnancy rate of artificial insemination. Methods A retrospective analysis of the 677 cases of ovulation induction, endometrial type and thickness, and fertilization frequency in our center from 2009 to 2010 was conducted. The total number of forward motility sperm was divided into 7 groups (A: (4 ~ 9) × 106 , B: (10-12) × 106, C: (13-15) × 106, D: (16-20) × 106, E: (21-25) × 106, F: (26-30) × 106 , G:> 30 × 106, respectively, the age of patients in each group, duration of infertility, activity rate of clinical pregnancy rate. Results A total of 88 biochemical pregnancies and 79 clinical pregnancies were obtained in 677 cycles. The average biochemical pregnancy rate was 13.15% and the clinical pregnancy rate was 11.81%. Ovulation program to HMG best, endometrial type for the third line and endometrial thickness greater than 8mm pregnancy is more than 10% of the necessary conditions. Double pregnancy rate of artificial insemination (15.27%) was significantly higher than a single (7.57%). Pregnancy rates of sperm count in each group were 0,14.37%, 11.92%, 15.09%, 8.33%, 20.34% and 6.06%, respectively. The pregnancy rate in group A was the lowest, and the difference was statistically significant compared with the other groups And the highest pregnancy rate, compared with the other groups, the difference was statistically significant. Conclusions The ovulation induction is the best in the HMG group. The third trimester endometrium with a thickness of more than 8mm, the density of (26 ~ 30) × 106 and the activity rate above 84% are prerequisites for obtaining high pregnancy rate. In a single.