生殖医学杂志

目的探讨影响供精人工授精临床妊娠率的相关因素。方法回顾性分析2015年1月至2016年12月在河北省计划生育科学技术研究院自愿接受供精人工授精的1 489对夫妇(共2 707个周期)的临床资料。采用Logistic回归分析探讨女方年龄、不育年限、促排卵方案、输卵管情况、注精次数与供精人工授精临床妊娠率的关系。结果女方年龄<35岁组的临床妊娠率(31.7%)显著高于女方年龄≥35岁组的临床妊娠率(22.4%)(P<0.05)。不育年限<5年、5~10年和≥10年组间比较,随着不育年限的增加,临床妊娠率有逐渐降低的趋势,但整体无显著性差异(P>0.05)。自然周期组的临床妊娠率(31.0%)与促排卵周期组的临床妊娠率(30.7%)比较,无显著性差异(P>0.05)。双侧输卵管通畅组的临床妊娠率(31.4%)有高于单侧输卵管通畅组(29.1%)的趋势,但二者比较无显著性差异(P>0.05)。单次注精组的临床妊娠率(23.4%)显著低于2次注精组的临床妊娠率(32.3%)(P<0.05)。Logistic回归分析发现,女方年龄、注精次数是影响供精人工授精临床妊娠率的重要因素。结论供精人工授精的临床妊娠率与女方年龄、授精手术次数有关,女方年龄小、两次注精可获得较理想的临床妊娠率。

Objective:To evaluate the factors affecting the pregnancy rate of artificial insemination with donor sperm(AID).Methods: The clinical data of 2 707 cycles of 1 489 couples undergone AID from January 2015 to December 2016 were retrospectively analyzed.The effects of women's age,infertility duration,ovarian stimulation regimens,tube factors and frequency of insemination on the pregnancy rate of AID were analyzed by using the single factor and multi-factors logistic regression analysis.Results:The pregnancy rate of AID cycles among women less than age 35 years was significantly higher than that of women aged ≥35 years(31.7%vs.22.4%)(P<0.05).The clinical pregnancy rate gradually decreased with the increase of infertile years,but there was no significant difference(P>0.05).Interestingly,there were no statistical differences in the pregnancy rate of AID between women with natural cycles and women with mildly hormonal stimulated cycles(31.0%vs.30.7%)(P>0.05),as well as between women with bilateral unblocked fallopian tubes and women with one blocked tube(31.4%vs.29.1%)(P >0.05).However,a significant difference in the pregnancy rate of AID was observedbetween once insemination and twice inseminations per cycle(23.4%vs.32.3%)(P <0.05).Logistic regression analysis found that the woman age and the insemination times were important factors affecting the clinical pregnancy rate of AID.Conclusions:Clinical pregnancy rate of artificial insemination with donor sperm is related to the woman's age and the insemination times.The women with younger age and twice inseminations can achieve a better clinical pregnancy rate.