【摘要】 目的:探讨影响供精人工授精(AID)成功率的各种临床因素及治疗对策。方法:121对夫妇行336个AID周期,其中6例行AID联合促排卵治疗3个周期以上未孕,遂改为供精IVF。结果:336个AID周期中共34例妊娠,周期妊娠率为10.1%。自然周期192例,周期妊娠率为7.2%。自然周期行宫颈管内人工授精(ICI)102周期,周期妊娠率为6.8%(7/102);宫腔内人工授精(IUI)82周期,周期妊娠率为7.3%(6/82);输卵管内精液灌注(FSP)8例,周期妊娠率为12.5%(1/8)。促排卵周期中,CC周期76例,HMG周期68例,妊娠率分别为7.8%和20.5%,两组相比较,HMG周期的妊娠率显著高于CC周期(P<0.05);CC周期和自然周期相比较无显著差异(P>0.05)。在CC和HMG促排卵周期中,均以FSP的妊娠率(16.6%和33.3%)最高(P<0.005),而ICl的周期妊娠率(3.1%和12.5%)显著低于IUI(10.5%和20.5%)和FSP(P<0.01)。6对夫妇行8个周期的供精IVF,周期妊娠率为50%(4/8)。结论:手术方式和促排卵方案的选择与AID的成功率密切相关,改变手术方式和促排卵方案可提高AID的成功率。更多还原

【Abstract】 Objective:To study the factors effeeting pregnancy rate of AID and to explore the best treatment protocol.Methods:A total of 121 infertile couple with azoospermia enlisted for AID and finished 336 cyales.Six patients who had experienced more 3 times AID in combination with HMG were failed to pregnancy,then chanrged to IVF-ET with donor semen.Results:34 cases gained pregnancies in 336 AID cycles,the pregnancy rate per cycle was 10.1%.Natural cycle were 192 cases,the pregnancy rate per cycle was 7.2%.In natural cycles,the the pregnancy rate per cycle of the operation method by intracervical insemination(lCD,intrauterine insemination(IUD and fallopian tube sperm perfusion(FSP) were expectively 6.8%,7.3%,12.5%.The group of FSP had gained the highest pregnancy rate compared with other groups(P<0.05).The pregnancy rate of AID in combination with HMG or CC were significiently higher than natural cycle(P<0.05).The highest preanancy rate was HMG combination with FSP(33.3%),and the lowest preanancy rate was CC combination with ICI(3.1%).Six couples who had undergone 8 cycles IVF-ET with donor semen acquired 4 pregnancies,the pregnancy rate per cycle was 50%.Conclusion:It may be improved the pregnancy rate by selecting optimum operation method and combination with HMG.更多还原