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[宫内人工授精妊娠的预后因素]

[Prognostic factors of pregnancy in intrauterine insemination].

作者信息

Barros Delgadillo Juan Carlos, Rojas Ruiz Juan Carlos, Molina Munguía Ana Cecilia, Villalobos Acosta Sergio, Sánchez Solís Víctor, Barroso Villa Gerardo, Gaviño Gaviño Fernando

机构信息

Departamento de Reproducción Asistida, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Lomas de Virreyes, CP, México, DF.

出版信息

Ginecol Obstet Mex. 2006 Dec;74(12):611-25.

Abstract

BACKGROUND

The artificial insemination is the introduction of spermatozoa in the feminine genital tract without carrying out sexual contact and with the purpose of obtaining the pregnancy. The insemination intrauterine has improved its rate of success thanks to the technological advances and the best knowledge of human reproductive physiology.

OBJECTIVES

To evaluate the prognostic factors for the pregnancy success and calculate the cumulative rate per cycle in IUI (intrauterine insemination).

PATIENTS AND METHODS

This study was descriptive, retrospective, analytic, and longitudinal. The cycles of IUI were analyzed from January 1st 2003 to December 31st 2005. Couples 24-41 years old with primary and secondary infertility were included. The following variables were studied: age of participant, type of infertility, length of infertility, aetiology, postcapacitation sperm density and motility, number of follicles, endometrial thickness, and the cycle number in which the IUI was performed. Patients carried out a protocol of ovarian stimulation and follicular follow up. The results were analyzed with 11.0 SPSS, continuous variables were analyzed and reported as means +/- SD with univariate logistic regression to determine statistic significance. Categoric variables were reported in frequencies and percentages. ROC curves were calculated to determine optimal cutting points.

RESULTS

668 cycles were analyzed in 391 couples. The pregnancy rate per cycle and couple was of 13.0 and 21.7% respectively. Means +/- SD patient age was 33.5 +/- 3.4 years old. The three variables with p < 0.05 were: the infertility duration, sperm motility and the cycle number in which IUI was performed. No statistical significance was found in the remaining variables.

CONCLUSIONS

The greatest success in IUI will be achieved with infertility of 4 years or less, with sperm motility of 77.6% and in the first two cycles of treatment.

摘要

背景

人工授精是指在不进行性接触的情况下将精子引入女性生殖道,目的是实现妊娠。由于技术进步和对人类生殖生理学的更深入了解,宫腔内人工授精的成功率有所提高。

目的

评估宫腔内人工授精(IUI)妊娠成功的预后因素,并计算每个周期的累积成功率。

患者与方法

本研究为描述性、回顾性、分析性和纵向研究。分析了2003年1月1日至2005年12月31日期间的IUI周期。纳入年龄在24至41岁之间的原发性和继发性不孕夫妇。研究了以下变量:参与者年龄、不孕类型、不孕时长、病因、精子获能后密度和活力、卵泡数量、子宫内膜厚度以及进行IUI的周期数。患者执行了卵巢刺激和卵泡监测方案。使用SPSS 11.0对结果进行分析,连续变量通过单因素逻辑回归分析并报告为均值±标准差,以确定统计学意义。分类变量以频率和百分比报告。计算ROC曲线以确定最佳切点。

结果

对391对夫妇的668个周期进行了分析。每个周期和每对夫妇的妊娠率分别为13.0%和21.7%。患者年龄的均值±标准差为33.5±3.4岁。p<0.05的三个变量为:不孕时长、精子活力以及进行IUI的周期数。其余变量未发现统计学意义。

结论

不孕时长4年或更短、精子活力为77.6%以及在治疗的前两个周期进行IUI,将获得最大的成功。

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