Lee Jisun, Hwang Suna, Lee Jaehun, Yoo Junghyun, Jang Dongmin, Hwang Kyungjoo, Kim Miran
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea.
Department of Obstetrics and Gynecology, Bundang Jesaeng General Hospital, Bungdang-gu, Korea.
J Obstet Gynaecol Res. 2018 Jun;44(6):1100-1106. doi: 10.1111/jog.13625. Epub 2018 Apr 19.
We investigated the effect of insemination timing on pregnancy outcomes in intrauterine insemination (IUI) cycles.
This is a retrospective study of 411 IUI cycles performed with a diagnosis of unexplained infertility and male factor infertility. The cycles were divided according to the interval between insemination and ovulation: ≤36 h, 36-37 h, 37-38 h and >38 h. The overall pregnancy rate, chemical pregnancy rate and clinical pregnancy rate were compared. We also analyzed the association between pregnancy outcomes and clinical characteristics, including age, duration of infertility, sperm concentration, body mass index (BMI), anti-Müllerian hormone (AMH) and number of mature follicles at ovulation.
There were no differences regarding age, duration of infertility, BMI, AMH, sperm concentration and number of mature follicles between different IUI timing groups. Sperm morphology was significantly lower in ≤36 h group (5.3 ± 1.4) compared to 36-37 h, 37-38 h and >38 h (6.3 ± 2.5 vs 6.5 ± 2.7 vs 6.5 ± 3.5, P = 0.004) groups. The ≤36 h group showed lowest total pregnancy rate (5.0%) compared to other IUI timings (21.8% vs 24.8% vs 20.0%, P = 0.05). Multivariate analysis showed that sperm morphology was associated with pregnancy in 36-37 h (odd ratio 1.42, 95% confidence interval 1.03-1.95, P = 0.02).
Insemination at least 36 h after ovulation is associated with increased pregnancy rate compared to IUIs performed ≤36 h following ovulation.
我们研究了宫腔内人工授精（IUI）周期中授精时机对妊娠结局的影响。
这是一项对411个IUI周期的回顾性研究，这些周期的诊断为不明原因不孕症和男性因素不孕症。根据授精与排卵之间的间隔将周期分为：≤36小时、36 - 37小时、37 - 38小时和>38小时。比较总体妊娠率、生化妊娠率和临床妊娠率。我们还分析了妊娠结局与临床特征之间的关联，包括年龄、不孕持续时间、精子浓度、体重指数（BMI）、抗苗勒管激素（AMH）以及排卵时成熟卵泡数量。
不同IUI时机组之间在年龄、不孕持续时间、BMI、AMH、精子浓度和成熟卵泡数量方面没有差异。≤36小时组的精子形态（5.3±1.4）明显低于36 - 37小时、37 - 38小时和>38小时组（分别为6.3±2.5、6.5±2.7和6.5±3.5，P = 0.004）。与其他IUI时机相比，≤36小时组的总妊娠率最低（5.0%）（分别为21.8%、24.8%和20.0%，P = 0.05）。多因素分析显示，在36 - 37小时，精子形态与妊娠相关（比值比1.42，95%置信区间1.03 - 1.95，P = 0.02）。
与排卵后≤36小时进行的IUI相比，排卵后至少36小时进行授精与妊娠率增加相关。
