Zeng Minhui, Wen Yanfei, Jiang Manbo, Xing Weijie, Tao Xin, Cai Liuhong
Center for Reproductive Medicine, The Third Affiliated Hospital, SunYat-SenUniversity, Guangzhou, China.
Mater Sociomed. 2015 Aug;27(4):248-50. doi: 10.5455/msm.2015.27.248-250.
Intrauterine insemination (IUI) is an important treatment for infertility. IUI combined with controlled ovarian stimulation (COS) is widely used because of the higher pregnancy rates compared to IUI cycles without COS.
We retrospectively analyzed a single center data from 458 patients underwent the first IUI cycle and had only 1 mature follicle from May 2009 to January 20144. 48 cycles were performed with Clomiphene citrate/Letrozole (CC/LE), 244 cycles with gonadotropins (Gn), 71 cycles with CC/LE+Gn, and 95 cycles in NC group.
Results showed that doctors preferred Gn protocol (53.3%) (p<0.05). Older patients were more likely to be allocated to CC/LE or NC group. 98.95% patients in NC group had regular menstruation cycle, with only 49.3% in CC/LE+Gn group (p<0.05). Estradiol (E2) level was much higher in COS groups than in NC group (p<0.05, for one mature follicle patients), and no significant differences were found within the COS groups. Duration of reaching follicles maturation was the shortest in Gn group and the longest in NC group, and NC group has the smallest follicular diameter (p<0.05).
No significances were found regarding the IUI outcomes. To sum up, doctors prefer COS for IUI. Patients' age, menstruation cycle, infertile etiology and ovary function were the main factors affecting doctors' selection of COS protocols.
宫腔内人工授精(IUI)是治疗不孕症的一种重要方法。IUI联合控制性卵巢刺激(COS)由于与未进行COS的IUI周期相比妊娠率更高而被广泛应用。
我们回顾性分析了2009年5月至2014年1月在本中心接受首次IUI周期且仅有1个成熟卵泡的458例患者的数据。使用枸橼酸氯米芬/来曲唑(CC/LE)进行了48个周期,使用促性腺激素(Gn)进行了244个周期,使用CC/LE+Gn进行了71个周期,非促排卵组(NC组)有95个周期。
结果显示医生更倾向于Gn方案(53.3%)(p<0.05)。年龄较大的患者更有可能被分配到CC/LE组或NC组。NC组98.95%的患者月经周期规律,而CC/LE+Gn组只有49.3%(p<0.05)。促排卵组的雌二醇(E2)水平明显高于NC组(对于仅有1个成熟卵泡的患者,p<0.05),且促排卵组之间未发现显著差异。Gn组达到卵泡成熟的时间最短,NC组最长,且NC组卵泡直径最小(p<0.05)。
未发现IUI结局存在显著差异。综上所述,医生在IUI时更倾向于使用COS。患者年龄、月经周期、不孕病因和卵巢功能是影响医生选择COS方案的主要因素。