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目的探讨影响促排卵周期宫腔内人工授精(intrauterine insemination,IUI)临床妊娠率相关因素。方法回顾性分析广州市妇女儿童医疗中心2011年1月至2015年9月行促排卵IUI治疗的805个周期,对女方年龄、不孕年限、授精周期数、授精次数、促排卵方案、优势卵泡数目、是否行人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)诱导排卵对临床妊娠率的影响进行分析。结果 1年龄<30组、31~36岁组、37~40组、>40组临床妊娠率分别为17.84%、16.59%、7.77%、0,差异有统计学意义(P<0.05)。2不孕年限<3年组、3~5年组、>5年组临床妊娠率分别为17.88%、14.44%、13.38%,随着不孕年限增加临床妊娠率呈下降趋势,但各组间差异无统计学意义(P>0.05)。3授精周期数为1、2、3、>3次者临床妊娠率分别为17.07%、15.56%、12.00%、10.34%,授精周期数增加临床妊娠率呈下降趋势,但各组间差异无统计学意义(P>0.05);同一周期中授精1次和2次临床妊娠率分别为15.20%、16.06%(P>0.05)。4氯米芬、来曲唑、氯米芬+尿促性素、来曲唑+尿促性素、尿促性素5种促排卵方案临床妊娠率分别为12.15%、13.73%、21.74%、19.15%、15.25%,差异无统计学意义(P>0.05)。5优势卵泡为1个临床妊娠率为12.17%,低于2个组(19.08%)、3个组(20.88%),(P<0.05)。6使用HCG诱导排卵组临床妊娠率为15.59%,略高于未使用HCG诱导排卵组(12.69%),但差异无统计学意义(P>0.05)。7 Logistic回归分析显示促排卵IUI妊娠成功率的主要因素是年龄和优势卵泡数目。结论患者年龄、授精周期数、优势卵泡数目是影响促排卵IUI临床妊娠率的主要因素。促排卵方案、授精次数、是否使用HCG诱导排卵等对促排卵IUI临床妊娠无影响。
Objective To investigate the factors that influence the clinical pregnancy rate of intrauterine insemination (IUI) during ovulation induction period. Methods A retrospective analysis of Guangzhou Women and Children Medical Center from January 2011 to September 2015 805 cycles of IUI treatment of ovulation, the woman’s age, age of infertility, number of fertilization cycles, fertilization frequency, ovulation induction program, the dominant follicle The effect of ovulation induced by human chorionic gonadotrophin (HCG) on clinical pregnancy rate was analyzed. Results The clinical pregnancy rates of 1 age <30 group, 31 ~ 36 years old group, 37 ~ 40 groups and> 40 group were 17.84%, 16.59%, 7.77%, 0 respectively, the difference was statistically significant (P <0.05). The clinical pregnancy rates of infertility <3 years group, 3 ~ 5 years group,> 5 years group were 17.88%, 14.44%, 13.38% respectively. The clinical pregnancy rate showed a decreasing trend with the increase of infertility years, The difference was not statistically significant (P> 0.05). 3, the number of insemination cycles was 1, 2 and 3, and the clinical pregnancy rates were> 17.07%, 15.56%, 12.00% and 10.34%, respectively. The increase of the number of insemination cycles showed a decreasing trend in clinical pregnancy rate, (P> 0.05). In the same period, the rates of primary and secondary clinical pregnancy were 15.20% and 16.06% respectively (P> 0.05). The clinical pregnancy rates of 5 ovulation induction programs of clomiphene citrate, letrozole, clomiphene citrate, urinary lecithin, letrozole, urinary urotropin, and urinary gonadotropin were 12.15%, 13.73%, 21.74% 19.15%, 15.25%, the difference was not statistically significant (P> 0.05). The prevalence of one dominant ovarian follicle was 12.17%, lower than 2 groups (19.08%), 3 groups (20.88%), (P <0.05). The clinical pregnancy rate of HCG-induced ovulation group was 15.59%, slightly higher than that of HCG-induced ovulation group (12.69%), but the difference was not statistically significant (P> 0.05). 7 Logistic regression analysis showed that the main factors contributing to the success of ovulation induction IUI pregnancy were age and number of dominant follicles. Conclusion The age of patients, the number of fertilization cycles and the number of dominant follicles are the main factors affecting the clinical pregnancy rate of ovulation-promoting IUI. Ovulation induction program, the number of insemination, whether or not to use HCG to induce ovulation and so on ovulation IUI clinical pregnancy had no effect.