Forges T, Monnier-Barbarino P
Centre d'Assistance Médicale à la Procréation, maternité régionale et universitaire, CHRU Nancy, 10, rue du Dr Heydenreich, 54042 Nancy, France.
Gynecol Obstet Fertil. 2004 Oct;32(10):904-10. doi: 10.1016/j.gyobfe.2004.07.017.
In unselected patients, the pregnancy rate after intrauterine insemination (i.u.i.) seldom goes beyond 10-15% per cycle. An insufficient number of spermatozoa at the fertilization site has been hypothesized for a long time to explain the low efficacy of this technique. Thus, the introduction of a larger number of male gametes into the female tubes has been thought of to give better results since the late eighties. First, a direct tubal catheterisation has been proposed for injection of spermatozoa, either by laparoscopy or transvaginally under ultrasound guidance or by tactile sensation. However, these procedures have been abandoned because of some severe traumatic and infectious complications. Alternatively, a spermatozoa suspension of several millilitres can be injected under pressure into the uterine cavity while sealing the cervical os, by various systems. This technique called Fallopian sperm perfusion (FSP) has yielded some interesting results, particularly in unexplained infertility. Nevertheless, the superiority of FSP over i.u.i. still remains controversial. This review describes the current knowledge about intratubal insemination and its potential role in the management of human infertility.
在未经过挑选的患者中，宫腔内人工授精（IUI）后的每个周期妊娠率很少超过10%-15%。长期以来，人们一直推测受精部位精子数量不足是导致该技术效率低下的原因。因此，自20世纪80年代末以来，人们就认为向女性输卵管内引入更多的雄配子会取得更好的效果。首先，有人提出通过腹腔镜检查、超声引导下经阴道或通过触感进行直接输卵管插管以注射精子。然而，由于一些严重的创伤性和感染性并发症，这些操作已被放弃。或者，可以通过各种系统在封闭宫颈口的同时将几毫升的精子悬液加压注入子宫腔。这种称为输卵管内精子灌注（FSP）的技术已经产生了一些有趣的结果，特别是在不明原因的不孕症中。然而，FSP相对于IUI的优越性仍然存在争议。这篇综述描述了关于输卵管内授精的当前知识及其在人类不孕症治疗中的潜在作用。
