Zhang Aiping, Ma Xiaoling, Zhang Lili, Zhang Xuehong, Wang Weihua
First Clinical Medical College, Lanzhou University.
Reproductive Medicine Hospital, First Hospital of Lanzhou University.
Medicine (Baltimore). 2019 Apr;98(16):e14975. doi: 10.1097/MD.0000000000014975.
Artificial insemination with donor sperm (AID) is a widely used procedure, but its success rate in China remains uncharacterized. This study investigated the factors associated with occurrence of clinical pregnancy and live birth and evaluated the birth outcomes in the offspring after AID in Northwest China.We retrospectively reviewed the results of 1805 AID courses in 1046 couples during 2006-2015. We analyzed whether the number of AID cycles, age of the female patient, and number of sperm with progressive motility were associated with the occurrence of clinical pregnancy and live birth. We also evaluated the birth outcomes in the offspring.Among the 1805 cycles, 447 (24.8%) resulted in clinical pregnancy and 384 (21.3%) resulted in a live birth. Miscarriage occurred in 57 of the 447 cases of clinical pregnancy (12.8%). The proportion of cycles resulting in a live birth decreased significantly with age (P < .001). The proportion of clinical pregnancies that resulted in miscarriage increased with age (P < .001). Cumulative pregnancy rate (the proportion of patients achieving a clinical pregnancy) increased progressively from 23.0% after 1 cycle to 42.7% after ≥5 cycles. The proportion of cycles resulting in clinical pregnancy did not vary with the total number of sperm with progressive motility administered per cycle. Multivariate logistic regression analysis revealed that superovulation treatment and number of cycles were factors associated with clinical pregnancy, while superovulation treatment, number of cycles, and patient age were factors associated with live birth. Among the 384 live births, only one case (0.3%) of birth defect (hexadactyly) was observed.In patients undergoing AID, clinical pregnancy is associated with superovulation treatment and number of cycles, and live birth is associated with superovulation treatment, number of cycles, and patient age. The risk of birth defects in the offspring after AID is low.
供精人工授精（AID）是一种广泛应用的程序，但在中国其成功率仍未明确。本研究调查了与临床妊娠和活产发生相关的因素，并评估了中国西北地区AID后子代的出生结局。我们回顾性分析了2006 - 2015年期间1046对夫妇1805个AID疗程的结果。我们分析了AID周期数、女性患者年龄以及具有前向运动能力的精子数量是否与临床妊娠和活产的发生相关。我们还评估了子代的出生结局。在1805个周期中，447个（24.8%）导致临床妊娠，384个（21.3%）导致活产。447例临床妊娠中有57例（12.8%）发生流产。活产周期比例随年龄显著下降（P < 0.001）。临床妊娠中发生流产的比例随年龄增加（P < 0.001）。累积妊娠率（实现临床妊娠的患者比例）从1个周期后的23.0%逐渐增加到≥5个周期后的42.7%。每个周期临床妊娠的周期比例与每个周期给予的具有前向运动能力的精子总数无关。多因素逻辑回归分析显示，超促排卵治疗和周期数是与临床妊娠相关的因素，而超促排卵治疗、周期数和患者年龄是与活产相关的因素。在384例活产中，仅观察到1例（0.3%）出生缺陷（多指畸形）。在接受AID的患者中，临床妊娠与超促排卵治疗和周期数相关，活产与超促排卵治疗、周期数和患者年龄相关。AID后子代出生缺陷的风险较低。
