精液预处理对IUI临床累积妊娠率的预测

摘要

Objective To study the effects of semen pretreatment on outcome of intrauterine insemination (IUI) clinical pregnancy before entering the cycle of IUI. Methods Clinical data of166 cases of IUI in our hospital reproductive cente from July 2010 to March 2013 were retrospectively analyzed. The effects of sperm morphology, forward movement sperm count and normal morphology sperm progressive motility total after semen pretreatment on the IUI clinical cumulative pregnancy rate were comparatively investigated. Results After semen pretreatment, the clinical cumulative pregnancy rate were 0%, 21.6%, 28.2% in the group with percentage of normal sperm morphology less than 4%, group less than 4~15% and group with more than 15%,respectively, the difference was statistically significant (P< 0.05); clinical cumulative pregnancy rate were 23.5%, 24.2% in group with forward movement sperm count less than 10×106 and group with more than 10×106 groups,, there was no significant difference (P>0.05); the clinical cumulative pregnancy rate were 4%, 33.3%, 26.1% in group with normal forward movement sperm number less than 0.4×106, group with 0.4~1.5×106 and group with more than 1.5×106, the differences were statistically significant (P<0.05). Conclusion After semen pretreatment, the percentage of normal sperm morphology has some predictive value on the outcome of IUI clinical cumulative pregnancy. When the normal form of sperm ≥4%, patients will get clinical stable cumulative pregnancy rate; after the number of the normal form of forward movement sperm has predictive value on IUI clinical cumulative pregnancy rate. When the number of normal morphology of forward movement spermmore than 0.4×106, patients will obtain stable cumulative pregnancy rate. Clinical cumulative pregnancy rate does not increase along with a further increase of the number of normal form of forward motile sperm , instead of a downward trend.%目的：探讨宫腔内人工授精（IUI）入周期前精液预处理结果对IUI临床妊娠结局的影响。方法回顾性分析我院生殖中心2010年7月至2013年3月166例IUI的临床资料，统计精液预处理后精子形态、前向运动精子总数及正常形态前向运动精子总数对IUI临床累积妊娠率的影响。结果166例精液预处理后正常形态精子百分率＜4%组与4%~15%组和≥15%组比较，其临床累积妊娠率分别为0%、21.6%、28.2%，差异有统计学意义（P＜0.05）；166例精液预处理后前向运动精子总数＜10×106组与≥10×106组比较，临床累积妊娠率分别为23.5%、24.2%，差异无统计学意义（P＞0.05）；166例精液预处理后正常形态前向运动精子总数＜0.4×106组与0.4~1.5×106组和≥1.5×106组比较，临床累积妊娠率分别为4%、33.3%、26.1%，差异有统计学意义（P＜0.05）。结论精液预处理后正常形态精子百分率对IUI临床累积妊娠率有一定的预测价值，当正常形态≥4%时，可获得较稳定的临床累积妊娠率；精液处理后正常形态前向运动精子总数对IUI临床累积妊娠率也有预测价值，当正常形态前向运动精子总数≥0.4×106时可获得较高的临床累积妊娠率，临床累积妊娠率不会随着正常形态前向运动精子总数的进一步增多而增高，反而会有下降趋势。