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评估宫腔内人工授精术后妊娠的影响因素:一项回顾性研究。

Evaluating The Effective Factors in Pregnancy after Intrauterine Insemination: A Retrospective Study.

作者信息

Ghaffari Firoozeh, Sadatmahalleh Shahideh Jahanian, Akhoond Mohammad Reza, Eftekhari Yazdi Poopak, Zolfaghari Zahra

机构信息

Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran ; Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

出版信息

Int J Fertil Steril. 2015 Oct-Dec;9(3):300-8. doi: 10.22074/ijfs.2015.4544. Epub 2015 Oct 31.

Abstract

BACKGROUND

Controlled ovarian hyperstimulation (COH) in conjunction with intrauterine inseminations (IUI) are commonly used to treat infertile couples. In this study we evaluated the relationship between IUI outcome and special causes of infertility. We also aimed to examine parameters that might predict success following IUI.

MATERIALS AND METHODS

In this cross-sectional study, we included 994 IUI cycles in 803 couples who referred to the infertility Institute. All statistical analyses were performed by using SPSS program, t tests and chi-square. Stepwise multiple linear regression analysis was performed to compare the association between dependent and independent variables. Logistic regression was conducted to build a prediction model of the IUI outcome.

RESULTS

Overall pregnancy rate per completed cycle (16.5%) and live birth rate per cycle (14.5%). The mean age in the pregnant group was significantly lower than that of the non-pregnant group (P=0.01).There was an association between cause of infertility and clinical pregnancies (P<0.001). Logistic regression identified four significant factors in determining the success of the IUI [menstrual irregularites (OR:2.3, CI:1.6-3.4, P<0.001), duration of infertility (OR:0.8, CI:0.8-0.9, P<0.001), total dose of gonadotropin (OR:1.02, CI:1.003-1.04, P=0.02) and semen volume (OR:1.1, CI:1.008-1.2, P=0.03)] which were the most predictive of IUI success.

CONCLUSION

Our study defined prognostic factors for pregnancy in COH+IUI. These variables can be integrated into a mathematical model to predict the chance of pregnancy rate in subsequent COH+IUI cycles.

摘要

背景

控制性卵巢过度刺激(COH)联合宫腔内人工授精(IUI)常用于治疗不孕夫妇。在本研究中,我们评估了IUI结局与特殊不孕原因之间的关系。我们还旨在研究可能预测IUI后成功的参数。

材料与方法

在这项横断面研究中,我们纳入了803对转诊至不孕不育研究所的夫妇的994个IUI周期。所有统计分析均使用SPSS程序、t检验和卡方检验进行。进行逐步多元线性回归分析以比较因变量和自变量之间的关联。进行逻辑回归以建立IUI结局的预测模型。

结果

每个完整周期的总体妊娠率为16.5%,每个周期的活产率为14.5%。妊娠组的平均年龄显著低于未妊娠组(P = 0.01)。不孕原因与临床妊娠之间存在关联(P < 0.001)。逻辑回归确定了决定IUI成功的四个重要因素[月经不规律(OR:2.3,CI:1.6 - 3.4,P < 0.001)、不孕持续时间(OR:0.8,CI:0.8 - 0.9,P < 0.001)、促性腺激素总剂量(OR:1.02,CI:1.003 - 1.04,P = 0.02)和精液量(OR:1.1,CI:1.008 - 1.2,P = 0.03)],这些是IUI成功的最具预测性的因素。

结论

我们的研究确定了COH + IUI中妊娠的预后因素。这些变量可整合到一个数学模型中,以预测后续COH + IUI周期的妊娠率机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c6/4671382/7d512c31f0cd/Int-J-Fertil-Steril-9-300-g01.jpg

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