Chen Li, Liu Qi
Department of Gynecology and Obstetrics, Nanjing University School of Medicine/Nanjing General Hospital of Nanjing Military Region, Nanjing, Jiangsu 210002, China.
Zhonghua Nan Ke Xue. 2009 Dec;15(12):1112-5.
To compare the results of the natural cycle and ovulation induction cycle in intrauterine insemination (IUI) for infertile couples of different ages.
We retrospectively analyzed 746 IUI cycles for 363 infertile couples, who were divided into a natural cycle (NC) and an ovulation induction cycle (OIC) group. The two groups were respectively subdivided into a < 35 yr and a > or = 35 yr age group, and, according to the drugs used, the OIC group was again divided into subgroups of clomiphene citrate + Progynova (CC + P), menopausal gonadotropin (HMG) and CC + HMG. The rates of clinical pregnancy, abortion and delivery were compared among different groups.
The pregnancy rate was significantly lower in the NC than in the OIC group (11.35% versus 19.61%, P < 0.01), but the rates of abortion and delivery had no significant differences between the two groups (P > 0.05), nor did the rate of clinical pregnancy among the subgroups of CC + P, HMG and CC + HMG (18.00%, 25.00% and 19.35%, P > 0.05). The < 35-year-old patients showed statistically lower rates of pregnancy and delivery in the NC than in the OIC group (P < 0.01 and P < 0.05), while the > or = 35-year-olds exhibited no significant differences in the rates of clinical pregnancy, abortion and delivery between the two groups.
The ovulation induction cycle could achieve a higher pregnancy rate than the natural cycle in IUI, whether with CC + P, HMG or CC + HMG, particularly for the infertile patients under 35 years. But the natural cycle is preferable for the > or = 35-year-olds.
比较不同年龄不孕夫妇行宫腔内人工授精（IUI）时自然周期和促排卵周期的结果。
回顾性分析363对不孕夫妇的746个IUI周期，将其分为自然周期（NC）组和促排卵周期（OIC）组。两组再分别分为年龄<35岁和≥35岁亚组，根据使用药物不同，OIC组又分为枸橼酸氯米芬+戊酸雌二醇（CC+P）、绝经后促性腺激素（HMG）及CC+HMG亚组。比较不同组间的临床妊娠率、流产率和分娩率。
NC组妊娠率显著低于OIC组（11.35%对19.61%，P<0.01），但两组流产率和分娩率无显著差异（P>0.05），CC+P、HMG及CC+HMG亚组间临床妊娠率也无显著差异（18.00%、25.00%和19.35%，P>0.05）。<35岁患者中，NC组妊娠率和分娩率在统计学上低于OIC组（P<0.01和P<0.05），而≥35岁患者两组间临床妊娠率、流产率和分娩率无显著差异。
IUI时，无论使用CC+P、HMG还是CC+HMG，促排卵周期的妊娠率均高于自然周期，尤其对于35岁以下的不孕患者。但≥35岁患者选择自然周期更佳
