Human Reproduction Unit, Cruces University Hospital, Biocruces, University of the Basque Country; Biocruces Health Research Institute, University of the Basque Country, Bilbao, Spain; Instituto Valenciano de Infertilidad, IVI Bilbao.
Human Reproduction Unit, Cruces University Hospital, Biocruces, University of the Basque Country.
Reprod Biomed Online. 2018 Feb;36(2):164-171. doi: 10.1016/j.rbmo.2017.11.002. Epub 2017 Nov 24.
The aim of this study was to ascertain the incidence of pelvic inflammatory disease (PID) after intrauterine insemination (IUI). A systematic review was conducted using three different approaches: a search of IUI registries; a search of published meta-analyses; and a search of prospective randomized trials. Search terms were 'IUI', 'complications', 'infection' and 'PID'. Two IUI registers were identified that met the inclusion criteria, totalling 365,874 cycles, with 57 PID cases being reported. The post-IUI PID rate was 0.16/1000 (95% CI 0.2 to 0.3/1000). The frequency was higher in husband sperm cycles (0.21/1000) (28/135,839) than in donor sperm cycles (0.03/1000) (1/33,712) (P < 0.05; OR 6.95). Nineteen meta-analyses were retrieved, which included 156 trials, totalling 43,048 cycles, with no PID case being reported. Seventeen prospective clinical trials published between 2013 and 2014 were identified, totalling 4968 cycles; no PID case was reported. The reported rate of post-IUI clinical PID is low (0.16/1000), about 40% higher than reported in the general population of women during their reproductive life. No antibiotic prophylaxis should be recommended unless there is an associated risk factor.
本研究旨在确定宫腔内人工授精（IUI）后盆腔炎（PID）的发生率。采用三种不同方法进行系统评价：IUI 注册研究检索；已发表的荟萃分析检索；前瞻性随机试验检索。检索词为“IUI”、“并发症”、“感染”和“PID”。确定了符合纳入标准的两个 IUI 登记处，共 365874 个周期，报告了 57 例 PID 病例。IUI 后 PID 的发生率为 0.16/1000（95%CI 0.2 至 0.3/1000）。丈夫精子周期（0.21/1000）（28/135839）的发生率高于供精周期（0.03/1000）（1/33712）（P<0.05；OR 6.95）。检索到 19 项荟萃分析，其中包括 156 项试验，共 43048 个周期，未报告 PID 病例。确定了 2013 年至 2014 年期间发表的 17 项前瞻性临床试验，共 4968 个周期；未报告 PID 病例。报告的 IUI 后临床 PID 发生率较低（0.16/1000），约比女性生育期人群报告的发病率高 40%。除非存在相关的危险因素，否则不应推荐使用抗生素预防。
