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目的探讨影响男性不育患者行宫腔内人工授精(IUI)临床妊娠的相关因素。方法回顾性分析337对不孕夫妇因男性因素行IUI共667周期的资料,分析男女双方年龄、不孕年限、女方体重指数(BMI)、促排卵方案以及处理后前向运动精子总数(PTMS)对临床妊娠率的影响。结果女方年龄≥35岁者临床妊娠率为12.6%,显著低于年龄<30岁者;男方年龄≥35岁者临床妊娠率为15.9%,显著低于年龄<35岁者;克罗米芬联合促性腺激素周期临床妊娠率为25.5%,显著高于自然周期;PTMS<5×106临床妊娠率为8.3%,显著低于PTMS≥10×106(P<0.05)。结论男性不育患者行IUI治疗过程中需要充分考虑男女双方年龄对治疗结局的影响,适时选择促排卵方案,以提高临床妊娠率;当PTMS<5×106,IUI妊娠率显著下降,建议行IVF-ET/ICSI-ET治疗以改善妊娠结局。
Objective To investigate the related factors that influence the intrauterine insemination (IUI) clinical pregnancy in male infertility patients. Methods The data of 667 cycles of IUI in 337 infertile couples were retrospectively analyzed. The age of men and women, duration of infertility, body mass index (BMI), ovulation induction program and the total number of PTMS after treatment were analyzed. Impact on clinical pregnancy rate. Results The clinical pregnancy rate was 12.6% in women of ≥35 years of age, significantly lower than those of <30 years of age. The clinical pregnancy rate in men ≥35 years of age was 15.9%, significantly lower than that of <35 years of age. Clomiphene combined with gonadal The clinical pregnancy rate of hormone cycle was 25.5%, which was significantly higher than that of natural cycle. The clinical pregnancy rate of PTMS <5 × 106 was 8.3%, which was significantly lower than that of PTMS≥10 × 106 (P <0.05). Conclusion IUI treatment of male infertility patients need to take full account of the age of both men and women on the treatment outcome, timely ovulation selection program to improve the clinical pregnancy rate; when the PTMS <5 × 106, IUI pregnancy rate decreased significantly, the proposed line IVF -ET / ICSI-ET treatment to improve pregnancy outcome.