完全受精失败与特发性亚生育力。

Total fertilization failure and idiopathic subfertility.

作者信息

Tanahatoe Sandra J, McDonnell Joseph, Goverde Angelique J, Hompes Peter G A, Lambalk Cornelis B

机构信息

Department of Obstetrics, Gynaecology and Reproductive Medicine, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands.

出版信息

Reprod Biol Endocrinol. 2009 Jan 12;7:3. doi: 10.1186/1477-7827-7-3.

DOI:10.1186/1477-7827-7-3

PMID:19138415

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2632644/

Abstract

BACKGROUND

To gain more insight in whether failure of intrauterine insemination (IUI) treatment in patients with idiopathic subfertility could be related to diminished fertilization, the aim of this study is to compare the fertilization of an initial IVF procedure after six cycles of IUI and the fertilization of an initial IVF procedure without preceding IUI cycles in couples with idiopathic subfertility.

METHODS

We performed a complimentary analysis of a randomized controlled trial, in which the number of total fertilization failure (TFF) in the first IVF procedure after unsuccessful IUI was compared to those of IVF without preceding IUI in patients with idiopathic subfertility. These patients participated in a previous study that assessed the cost effectiveness of IUI versus IVF in idiopathic subfertility and were randomized to either IUI or IVF treatment.

RESULTS

45 patients underwent IVF after 6 cycles of unsuccessful IUI and 58 patients underwent IVF immediately without preceding IUI. In 7 patients the IVF treatment was cancelled before ovum pick. In the IVF after unsuccessful IUI group TFF was seen in 2 of the 39 patients (5%) versus 7 of the 56 patients (13%) in the immediate IVF group. After correction for confounding factors the TFF rate was not significantly different between the two groups (p = 0.08, OR 7.4; 95% CI: 0.5-14.9).

CONCLUSION

Our data showed that TFF and the fertilization rate in the first IVF treatment were not significantly different between couples with idiopathic subfertility undergoing IVF after failure of IUI versus those couples undergoing IVF immediately without prior IUI treatment. Apparently, impaired fertilization does not play a significant role in the success rate of IUI in patients with idiopathic subfertility.

摘要

背景

为了更深入了解特发性亚生育力患者宫内人工授精（IUI）治疗失败是否与受精减少有关，本研究旨在比较特发性亚生育力夫妇在进行六个周期IUI后首次体外受精（IVF）程序的受精情况与未进行过IUI周期的首次IVF程序的受精情况。

方法

我们对一项随机对照试验进行了补充分析，比较了特发性亚生育力患者在IUI失败后首次IVF程序中的总受精失败（TFF）数量与未进行过IUI的IVF患者的TFF数量。这些患者参与了之前一项评估IUI与IVF在特发性亚生育力中的成本效益的研究，并被随机分配接受IUI或IVF治疗。

结果

45例患者在6个周期的IUI失败后接受了IVF，58例患者未进行过IUI直接接受了IVF。7例患者在取卵前取消了IVF治疗。在IUI失败后进行IVF的组中，39例患者中有2例（5%）出现TFF，而在直接进行IVF的组中，56例患者中有7例（13%）出现TFF。在校正混杂因素后，两组的TFF率无显著差异（p = 0.08，OR 7.4；95% CI：0.5 - 14.9）。