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[供精人工授精对妊娠结局及子代安全性的影响]

[Influence of artificial insemination with donor sperm on the pregnancy outcomes and safety of the offspring].

作者信息

Liu Ying, Liu Xin-yu, Wang Bing-song, Wang Bao-sheng, Xu Cheng-sheng, Li Hui

出版信息

Zhonghua Nan Ke Xue. 2016 Mar;22(3):229-32.

Abstract

OBJECTIVE

To investigate the factors influencing the pregnancy outcomes of artificial insemination with donor sperm (AID), improve the pregnancy rate, and evaluate the safety of the offspring.

METHODS

We retrospectively analyzed 7,761 cycles of AID for 5,109 infertile couples performed between July 1, 2005 and June 30, 2013 in the Center of Reproductive Medicine of Shenyang No 204 Hospital, the outcomes of pregnancy, and the incidence of birth defects.

RESULTS

Totally, 2 252 clinical pregnancies were achieved by AID, in which the pregnancy rate per cycle was 29. 02% and the cumulative pregnancy rate was 44. 08%. The clinical pregnancy rate was remarkably higher in the females of ≤ 35 years than in those of > 35 years old (30.31% vs 20.18%, P < 0.01), in the women with < 5-year infertility than in those with > 5-year infertility (30.83% vs 28.16%, P < 0.01), and in the patients of the ovarian stimulation group than in those of the natural cycle group (33.22% vs 28.68%, P < 0.01) The clinical pregnancy rate was the highest in the first treatment cycle (29.87%), with statistically significant difference from the fourth cycle (23.61%) (P < 0.05), but not between the other cycles (P > 0.05). There were 28 cases of birth defects in the offspring (1.40%), including 6 cases (21.43%) involving the cardiovascular system, 4 (14.29%) involving the musculoskeletal system, 3 (10.71%) involving the urogenital system, 3 (10.71%) involving the central nervous system, 2 cases (7.14%) of cleft lip and palate, 2 (7.14%) involving the respiratory system, 2 (7.14%) involving the gastrointestinal digestive system, and other anomalies.

CONCLUSION

Female age, infertility duration, and ovarian stimulation treatment are important factors influencing the clinical pregnancy rate of AID. Artificial insemination with cryopreserved donor sperm does not increase the incidence of birth defects, which is considered as a relatively safe technique of assisted reproduction.

摘要

目的

探讨影响供精人工授精(AID)妊娠结局的因素,提高妊娠率,并评估子代安全性。

方法

回顾性分析2005年7月1日至2013年6月30日在沈阳204医院生殖医学中心为5109对不孕夫妇实施的7761周期AID的妊娠结局及出生缺陷发生率。

结果

AID共获得2252例临床妊娠,每周期妊娠率为29.02%,累积妊娠率为44.08%。≤35岁女性的临床妊娠率显著高于>35岁女性(30.31%对20.18%,P<0.01);不孕年限<5年的女性高于>5年的女性(30.83%对28.16%,P<0.01);促排卵组患者高于自然周期组(33.22%对28.68%,P<0.01)。临床妊娠率在第1治疗周期最高(29.87%),与第4周期(23.61%)相比差异有统计学意义(P<0.05),其他周期之间差异无统计学意义(P>0.05)。子代出生缺陷28例(1.40%),其中心血管系统6例(21.43%)、肌肉骨骼系统4例(14.29%)、泌尿生殖系统3例(10.71%)、中枢神经系统3例(10.71%)、唇腭裂2例(7.14%)、呼吸系统2例(7.14%)、胃肠道消化系统2例(7.14%)及其他畸形。

结论

女性年龄、不孕年限及促排卵治疗是影响AID临床妊娠率的重要因素。冷冻供精人工授精不增加出生缺陷发生率,是一种相对安全的辅助生殖技术。

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