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精液特征对宫腔内人工授精后妊娠率的影响。

Effect of semen characteristics on pregnancy rate following intrauterine insemination.

作者信息

Dorjpurev Uranchimeg, Kuwahara Akira, Yano Yuya, Taniguchi Tomoko, Yamamoto Yuri, Suto Ayako, Tanaka Yu, Matsuzaki Toshiya, Yasui Toshiyuki, Irahara Minoru

机构信息

Department of Obstetrics and Gynecology, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.

出版信息

J Med Invest. 2011 Feb;58(1-2):127-33. doi: 10.2152/jmi.58.127.

Abstract

OBJECTIVE

To assess the effects of semen characteristics on the success of intrauterine insemination (IUI).

DESIGN

A retrospective study.

SETTINGS

The Department of Obstetrics and Gynecology, Tokushima University Hospital, Japan.

PATIENTS

Between 2004 and 2008, 1,177 IUI cycles in 283 couples were studied.

INTERVENTION

IUI cycles were preceded with ovarian stimulation.

MAIN OUTCOME MEASURE

Clinical pregnancy.

RESULT

A total of 82 clinical pregnancies were obtained (7.0% pregnancy rate per cycle, 28.9% per case). Their subsequent outcomes of pregnancies were 18 miscarriages (21.9%), 2 ectopic pregnancies (2.4%) and 60 live births (73.2%). Of the 82 clinical pregnancies, 2 were twin pregnancies (2.4%). There was no triple or higher order multiple pregnancies. At the end of the sixth cycle, 73 clinical pregnancies had been achieved (89.0%). After diagnostic laparoscopy, the pregnancy rate per cycle for patients ≤ 35 years age was 18%, which is significantly higher than that of patients >35 years of age. Pregnancies occurred up to the fifth cycle after laparoscopy. The pregnancy rate (PR) per cycle was significantly higher in cases of sperm movement rates more than 30% (PR 9.3%) and total motile sperm counts more than 10 × 10(6)/ml (PR 8.2%). A study comparing the washed and unwashed cases did not reveal any differences.

CONCLUSION

In male sub-fertility cases of sperm parameters as motility rates ≥ 30% and motile sperm concentration ≥ 10 × 10(6)/ml, IUI could be a useful option for infertility treatment.

摘要

目的

评估精液特征对宫腔内人工授精(IUI)成功率的影响。

设计

一项回顾性研究。

地点

日本德岛大学医院妇产科。

患者

2004年至2008年期间,对283对夫妇的1177个IUI周期进行了研究。

干预措施

IUI周期前进行卵巢刺激。

主要观察指标

临床妊娠。

结果

共获得82例临床妊娠(每个周期妊娠率7.0%,每例患者妊娠率28.9%)。其后续妊娠结局为18例流产(21.9%)、2例异位妊娠(2.4%)和60例活产(73.2%)。在82例临床妊娠中,2例为双胎妊娠(2.4%)。无三胎或更高阶多胎妊娠。在第六个周期结束时,已实现73例临床妊娠(89.0%)。诊断性腹腔镜检查后,年龄≤35岁患者的每个周期妊娠率为18%,显著高于年龄>35岁的患者。腹腔镜检查后直至第五个周期均有妊娠发生。精子运动率超过30%(妊娠率9.3%)和总活动精子数超过10×10⁶/ml(妊娠率8.2%)的病例中,每个周期妊娠率显著更高。一项比较洗涤和未洗涤病例的研究未发现任何差异。

结论

在精子参数如运动率≥30%和活动精子浓度≥10×10⁶/ml的男性不育病例中,IUI可能是治疗不孕症的一种有效选择。

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