【摘要】 目的:探讨几种因素对宫腔内人工授精(IUI)结局的影响。方法:回顾性分析本院2007年10月～2009年6月行夫精IUI135对夫妇,共278周期。分析序贯使用低剂量缓增法和剂量递减法促排卵、促性腺激素释放激素激动剂(GnRH-a)诱导排卵、卵泡直径、IUI治疗周期、助孕指征与妊娠结局的关系。结果:排卵障碍者序贯使用低剂量缓增法和剂量递减法促排卵IUI,妊娠率与自然周期IUI一致。多卵泡发育者和既往卵泡黄素化未破裂(LUF)者用Gn-RH-a诱导排卵取得了与人绒毛膜促性腺激素(hCG)相似的排卵率与妊娠率,降低了卵巢过度刺激综合征(OHSS)的发生率和程度。本资料无多胎妊娠发生。IUI妊娠率与助孕指征有关(P=0.01),与hCG日优势卵泡直径无关(P>0.05)。3周期失败后继续IUI治疗获得了与前3周期相似的累积妊娠率,但并发症尤其是异位妊娠的发生率增加(P=0.018)。结论:序贯使用低剂量缓增法和剂量递减法促排卵结合IUI治疗安全有效,GnRH-a诱导排卵有效,降低OHSS及多胎妊娠几率。更多还原

【Abstract】 Objective:To explore some factors related to the outcomes of intrauterine insemination(IUI).Methods:A total of 135 couples(278 cycles)were treated with artificial insemination with husband sperm between October 2007 and June 2009 in the Affiliated Hospital of Research Institute for Family Planning of Liaoning Province.The impact of ovulation induction with low-dose step-up and step-down regimens of human menopausal gonadotropin(hMG),gonadotropin-releasing hormone angonist(GnRHa)for inducing ovulation,diameter of dominant follicles,IUI cycle number,indications of assisted reproduction on the pregnancy outcomes of IUI were evaluated.Results:After ovulation induction with low-dose step-up and step-down regimens of hMG,the infertile women with ovulatory dysfunction had the same clinical pregnancy rate(CPR)as those with natural ovulation cycles.With regard to the women with polyovular folliclular development and luteinized unruptured follicle,ovulation induction with GnRHa resulted in the same ovulation rate and CPR as human chorionic gonadotropin(hCG).The incidence of ovarian hyperstimulation syndrome and its severity reduced.No multiple-fetus pregnancy(MFP)occurred.The CPR was related to the indications of assisted reproduction(P=0.01),and had no relation with the diameter of dominant follicle on the hCG-day(P>0.05).After 3 failed cycles,the continuing IUI treatment resulted in the same cumulative CPR as the first 3 cycles.But the incidence of the complications increased,especially ectopic pregnancy(P=0.018).Conclusion:The ovulation induction with low-dose step-up and step down regimens of hMG in IUI is safe and effective.And GnRHa is effective in ovulation induction.更多还原