Thijssen Annelies, Creemers An, Van der Elst Wim, Creemers Eva, Vandormael Eva, Dhont Nathalie, Ombelet Willem
Genk Institute for Fertility Technology, Department of Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium; Hasselt University, Department of Physiology, Martelarenlaan 42, 3500 Hasselt, Belgium.
Hasselt University, Center for Statistics (CENSTAT), Agoralaan Building D, 3590 Diepenbeek, Belgium.
Reprod Biomed Online. 2017 May;34(5):463-472. doi: 10.1016/j.rbmo.2017.01.016. Epub 2017 Feb 24.
The aim was to examine the value of different covariates in the prediction of intrauterine insemination (IUI) success. Between July 2011 and September 2015, data from 1401 IUI cycles with homologous semen in 556 couples were collected prospectively, by questionnaire, in a tertiary referral infertility centre. Statistical analysis was performed using generalized estimating equations (GEEs). GEEs were used instead of an ordinary logistic regression model to take into account the correlation between observations from the same person. The primary outcome parameter was clinical pregnancy rate (CPR), confirmed with a gestational sac and fetal heartbeat on ultrasonography at 7-8 weeks. An overall CPR of 9.5% per cycle was observed. Univariate statistical analysis revealed female and male age, male smoking, female body mass index, ovarian stimulation and inseminating motile count (IMC) as covariates significantly influencing CPR per cycle. Multivariate GEE analysis revealed that the only valuable prognostic covariates included female age, male smoking and infertility status (i.e. primary/secondary infertility). IMC showed a significant curvilinear relationship, with first an increase and then a decrease in pregnancy rate.
目的是研究不同协变量在预测宫腔内人工授精（IUI）成功率方面的价值。2011年7月至2015年9月期间，在一家三级转诊不孕症中心，通过问卷调查前瞻性收集了556对夫妇1401个使用同源精液的IUI周期的数据。使用广义估计方程（GEEs）进行统计分析。使用GEEs而非普通逻辑回归模型，以考虑来自同一人的观察值之间的相关性。主要结局参数是临床妊娠率（CPR），通过在7 - 8周时超声检查发现妊娠囊和胎心来确认。观察到每个周期的总体CPR为9.5%。单变量统计分析显示，女性和男性年龄、男性吸烟情况、女性体重指数、卵巢刺激和授精活动精子计数（IMC）作为协变量显著影响每个周期的CPR。多变量GEE分析显示，唯一有价值的预后协变量包括女性年龄、男性吸烟情况和不孕状态（即原发性/继发性不孕）。IMC呈现出显著的曲线关系，妊娠率先是上升，然后下降。
