1855个供精人工授精周期妊娠率影响因素分析

摘要

Objective To study the influence of various factors on clinical pregnancy rate of artificial insemination by donor (AID).Methods One thousand eight hundred and eighty‐five AID cycles for 874 couples were analyzed from October 2009 to December 2015 ,and the relationship between various factors and AID clinical pregnancy rate was dis‐cussed .Results ① AID clinical pregnancy rate was gradually declined with age , the rate of < 30 years old group (31.2% ) was the highest ,that of 30‐34 group and 35‐39 group were 25.1% and 23.0% ,respectively .And the rate of≥40 group was the lowest ( P<0.05);②AID clinical pregnancy rate was not statistically sagnificant ( P>0.05);③The pregnancy rate of secondary infertility group AID was higher (42.0% ) than that of the primary infertility group (28.5% ) significantly( P<0.05);④The pregnancy rate of bilateral and unilateral fallopian tubes patency group were not statistically segnificant;⑤The rate of natural cycle group and drug stimulating ovulation cycle group were not statisti‐cally segnificant;⑥The rate of the group with IUI implied after ovulation or before and after ovulation was not statistical‐ly sagnificant ;⑦The rate of 1‐5 cycle groups were 32.5% ,26.6% ,26.6% ,21.2% and 28.6% ,respectively ,and the≥6 cycles group was significantly decreased to 9 .1% ( P<0.05).Conclusion The woman′s age is the main factor in‐fluencing the AID clinical pregnancy rate .Drugs of stimulating ovulation cycle will not increase AID clinical pregnancy rate .The patients without other infertility factors can be treated with AID for 4‐5 cycles before other methods.%目的：探讨多种因素对供精人工授精（A ID ）临床妊娠率的影响。方法分析2009年10月至2015年12月我中心874对夫妇完成的1855个AID周期，探讨各种因素与AID临床妊娠率的关系。结果①＜30岁组A ID临床妊娠率（31．2％）最高，30～34岁组妊娠率25．1％，35～39岁组妊娠率23.0％，≥40岁组妊娠率（12.0％）明显下降（ P ＜0.05）；②不孕年限差异无统计学意义（ P ＞0.05）；③继发不孕组 AID临床妊娠率（42.0％）较原发不孕组妊娠率（28.5％）高（ P ＜0.05）；④双侧与单侧输卵管通畅组AID妊娠率差异无统计学意义（ P ＞0.05）；⑤自然周期组与药物促排卵周期组妊娠率差异无统计学意义（ P ＞0.05）；⑥同一周期内，排卵前后2次宫腔内人工授精（IUI）组与排卵后1次宫腔内人工授精组妊娠率差异无统计学意义（ P＞0.05）；⑦AID周期数与临床妊娠率比较：1个周期妊娠率（32.5％）最高，2个周期妊娠率26.6％、3个周期妊娠率26.6％、4个周期妊娠率21.2％、5个周期妊娠率28.6％，≥6个周期妊娠率（9.1％）明显下降（ P ＜0.05）。结论女方年龄是影响A ID临床妊娠率的主要因素。药物促排卵周期不增加A ID临床妊娠率。不伴有女方不孕因素患者，可给予A ID治疗4～5个周期后再改行其他助孕方式。