Sikandar Rozina, Virk Sadia, Lakhani Shehnaz, Sahab Huma, Rizvi Javed
Department of Obstetrics and Gynaecology, The Aga Khan University Hospital, Karachi, 74800-Pakistan.
J Coll Physicians Surg Pak. 2005 Dec;15(12):782-5.
To determine the success rate of intrauterine insemination (IUI), following controlled ovarian hyperstimulation (COH) and to identify the prognostic factors associated with successful outcome in couples undergoing this form of assisted reproduction.
Case series.
Concept Fertility Centre, Karachi, Pakistan from January - December 2004.
A total of 290 IUI procedures carried out for the treatment of unexplained and male factor subfertility were included. The age of women ranged from 20 to 44 years and the duration of subfertility were variable. All women had tubal patency confirmed before undergoing COH with one of the three regimens. IUI was performed at follicular maturity of > 16 mm and endometrial thickness of > 7 mm. Main outcome measures analyzed were pregnancy rate per cycle of IUI, miscarriage rate and ongoing pregnancy rate. Other variables observed were the various prognostic factors associated with successful outcome in IUI, such as maternal age, effect of different regimen of COH, motile sperm count and numbers of pre-ovulatory mature follicles > 16 mm. Data was collected and entered in SPSS version 10. Chi- square test of significance was applied and p-value determined.
The cycle pregnancy rate (CPR), miscarriage rate and ongoing pregnancy rate was 10%, 13.8% and 8.6% respectively. CPR was 12% in women <35 years compared to 3% in >35 years (p-value 0.03). Significant difference was not observed in the CPR with three different COH regimes. CPR increased dramatically with motile sperm count of >10 millions/ml compared with < 10 millions/ml (12.3% vs. 2.8%, p-value 0.02). Significantly higher pregnancy rate was observed with increasing number of mature follicles >16 mm (6.2%, 12.9% and 30% with one, two and three follicles, p-value 0.0019). There was no case of OHSS and only one case of twin gestation.
The overall CPR in patients undergoing IUI following COH at our clinic is comparable to the pregnancy rates as shown in different studies. Younger age, motile sperm count of > 10 millions/ml and two or three mature follicles >16 mm are good prognostic factors for successful outcome. However, no significant difference was observed in CPR with different COH regimes.
确定在控制性卵巢过度刺激（COH）后进行宫腔内人工授精（IUI）的成功率，并识别接受这种辅助生殖形式的夫妇中与成功结局相关的预后因素。
病例系列研究。
2004年1月至12月在巴基斯坦卡拉奇的概念生育中心。
共纳入290例因不明原因和男性因素导致的不育症而进行的IUI手术。女性年龄在20至44岁之间，不育时间各不相同。所有女性在采用三种方案之一进行COH之前均确认输卵管通畅。在卵泡成熟度>16mm且子宫内膜厚度>7mm时进行IUI。分析的主要结局指标为每个IUI周期的妊娠率、流产率和持续妊娠率。观察的其他变量包括与IUI成功结局相关的各种预后因素，如产妇年龄、不同COH方案的效果、活动精子计数以及>16mm的排卵前成熟卵泡数量。收集数据并录入SPSS 10版。应用卡方显著性检验并确定p值。
周期妊娠率（CPR）、流产率和持续妊娠率分别为10%、13.8%和8.6%。<35岁女性的CPR为12%，而>35岁女性为3%（p值0.03）。三种不同COH方案的CPR未观察到显著差异。活动精子计数>1000万/ml时CPR显著高于<1000万/ml（12.3%对2.8%，p值0.02）。随着>16mm成熟卵泡数量增加，妊娠率显著升高（一个、两个和三个卵泡时分别为6.2%、12.9%和30%，p值0.0019）。未发生卵巢过度刺激综合征（OHSS）病例，仅1例双胎妊娠。
在我们诊所接受COH后进行IUI的患者总体CPR与不同研究中显示的妊娠率相当。年龄较小、活动精子计数>1000万/ml以及两个或三个>16mm的成熟卵泡是成功结局的良好预后因素。然而，不同COH方案的CPR未观察到显著差异。
