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目的:探讨供精人工授精(AID)的临床应用价值。方法:回顾性分析2008年1月至2009年3月在本中心治疗的258对夫妇共行480个AID治疗周期,根据女方年龄分成≤30岁和≥31岁两组。结果:480个AID治疗周期共获得120例临床妊娠,周期妊娠率为25.00%,累积妊娠率达46.51%。≤30岁和≥31岁两组在自然周期方案中周期妊娠率分别是29.65%、13.33%,累积妊娠率分别是51.00%、25.00%,两者间差异均有显著性(P<0.05);在促排卵方案中,两组周期妊娠率分别为24.02%、23.81%,累积妊娠率分别为48.86%、43.48%,差异均无显著性(P>0.05)。随着女性年龄增长,不孕年限延长,两组AID的周期妊娠率和累积妊娠率下降,但是无统计学差异。前4个周期的周期累积妊娠率分别为24.03%、24.94%、24.69%和25.00%,无明显差异(P>0.05);第一周期与后三个治疗周期的累积妊娠率分别是24.03%、39.53%、45.74%和46.51%,有显著升高趋势(P<0.01)。结论:①在AID治疗中女方年龄增高,促排卵授精方案优于自然周期授精方案。②AID至少应进行3～4次,未成功者再求助于试管婴儿等其他辅助生殖技术。
Objective: To investigate the clinical value of artificial insemination (AID). Methods: A total of 480 AID treatment cycles were performed in 258 couples treated in our center from January 2008 to March 2009. The treatment groups were divided into two groups of ≤30 years old and ≥31 years old according to the woman’s age. Results: A total of 120 clinical pregnancies were obtained during the 480 AID cycles. The pregnancy rate was 25.00% and the cumulative pregnancy rate was 46.51%. The pregnancy rates of patients in the age group of ≤30 years and ≥31 years were 29.65% and 13.33% respectively, and the cumulative pregnancy rates were 51.00% and 25.00% respectively. There was significant difference between the two groups (P <0.05). In the ovulation induction program, the pregnancy rates of the two groups were 24.02% and 23.81% respectively, and the cumulative pregnancy rates were 48.86% and 43.48%, respectively, with no significant difference (P> 0.05). With the increase of women’s age and the prolonged period of infertility, the cycle pregnancy rate and cumulative pregnancy rate of AID in both groups decreased, but there was no statistical difference. The cumulative pregnancy rates in the first 4 cycles were 24.03%, 24.94%, 24.69% and 25.00%, respectively (P> 0.05). The cumulative pregnancy rates in the first and last three treatment cycles were 24.03% 39.53%, 45.74% and 46.51% respectively, with a significant increase trend (P <0.01). Conclusion: ① In the AID treatment, the woman’s age is higher than that of the natural cycle insemination program. ② AID should be carried out at least 3 to 4 times, unsuccessful and then resorted to IVF and other assisted reproductive technology.