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目的分析宫腔内人工授精(IUI)及后续体外受精-胚胎移植(IVF-ET)助孕的临床结局。方法回顾性分析2011年1月-2014年12月在该中心接受IUI助孕的患者407例及后续IVF-ET治疗的患者217例的临床资料,分析IUI及后续IVF-ET助孕的临床结局。结果 IUI的临床妊娠率为14.5%,年龄≥35岁组的妊娠率明显低于<30岁组(P<0.05),IUI助孕周期各组间妊娠率比较,差异无统计学意义(P均>0.05);217例患者IUI失败后转行IVF治疗,临床妊娠率为42.4%,根据患者年龄分组,在各组内分别按1次、2次、3次IUI失败后转行IVF-ET治疗的情况进行分析比较,年龄<30岁和30~34岁各组间Gn用量、Gn天数、获卵数、移植胚胎数、卵子成熟率、受精率、卵裂率、优质胚胎率、妊娠率和着床率比较,差异均无统计学意义(P>0.05);年龄≥35岁组中IUI失败3次患者的胚胎着床率明显低于IUI失败1次者(P<0.05)。结论年龄是影响IUI助孕成功率的重要因素。≤34岁患者可适当增加IUI周期数以提高妊娠率,≥35岁患者应尽早接受IVF-ET治疗,以增加获得妊娠的机会。
Objective To analyze the clinical outcomes of intrauterine insemination (IUI) and subsequent in vitro fertilization-embryo transfer (IVF-ET). Methods A retrospective analysis of clinical data of 407 patients with IUI-assisted pregnancy and 217 patients with subsequent IVF-ET in the center from January 2011 to December 2014 was performed. The clinical outcomes of IUI and subsequent IVF-ET assisted pregnancy were analyzed . Results The clinical pregnancy rate of IUI was 14.5%. The pregnancy rate of patients aged 35 or older was significantly lower than that of patients <30 (P <0.05). There was no significant difference in pregnancy rates between IUI groups > 0.05). After IUI failed, 217 patients were switched to IVF. The clinical pregnancy rate was 42.4%. According to the patient’s age, IVF-ET treatment was carried out after 1, 2, 3 IUI failure respectively The levels of Gn, days of Gn, number of oocytes retrieved, number of embryos transferred, egg maturation rate, fertilization rate, cleavage rate, quality embryo rate, pregnancy rate and implants were compared among groups <30 years old and 30-34 years old (P> 0.05). The implantation rate of IUI patients who failed three times in age≥35 years was significantly lower than that in IUI patients who failed once (P <0.05). Conclusion Age is an important factor that influences the success rate of IUI assisted pregnancy. Patients ≤34 years of age may be appropriate to increase the number of IUI to improve pregnancy rate, ≥35 years old patients should receive IVF-ET treatment as soon as possible to increase the chance of getting pregnant.