目的：应用密度梯度离心法和直接上游法处理不明原因不孕和轻度精液异常患者的精液，比较两种方法对宫腔内人工授精（IUI）临床妊娠率的影响。方法：回顾性分析2013年1月至2014年12月期间，在我中心进行促排卵＋IUI的571个周期患者，统计其精液优化处理方法和临床妊娠率。结果：总体临床妊娠率为密度梯度离心法（17．8％）显著高于直接上游法（11．4％）（P ＜0．05）；不明原因不孕组的临床妊娠率为密度梯度离心法（33．7％）显著高于直接上游法（20．3％）（P ＜0．05）；轻度精液异常组的临床妊娠率为密度梯度离心法（11．6％）显著高于直接上游法（7．6％）（P ＜0．05）。结论：密度梯度离心法相对直接上游法能有效提高因不明原因不孕和轻度精液异常患者IUI的临床妊娠率。%Objective To compare the efficacy of gradient and swim-up semen preparation techniques on pregnancy rates in couples undergoing intrauterine insemination (IUI) cycles with human menopausal gonadotropin (HMG) stimulation. Methods Five hundred and seventy one cycles were devided into the swim up or the gradient technique groups for sperm preperation. The clinical pregnancy rates per cycle were evaluated. Results The clinical pregnancy rates per cycle were significantly higher in the gradient group (17.8%) than that in the swim up group (11.4%)(P < 0.05). In the subgroup of unexplained subfertile couples, the gradient group also revealed significantly higher clinical pregnancy rates per cycle (33.7%) than that in the swim up group (20.3%)(P<0.05). In couples with mild male factor subfertility, the gradient group also revealed significantly higher clinical pregnancy rates per cycle (11.6%) than that in the swim up group (7.6%)(P < 0.05). Conclusion The gradient technique significantly improves clinical outcome in IUI cycles of unexplained subfertile and male subfertile couples.
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