宫腔内人工授精作为不孕夫妇的首要可行选择：一家私立中心的患者评估
Intrauterine insemination as a primary viable option to infertile couples: evaluation of patients in a private center.
作者信息
Bonow Marília Porto, Donne Ricardo Ditzel Delle, Rosa Vinicius Bonato da, Lucca José Augusto, Hillesheim Cristian Maio, Schuffner Alessandro
机构信息
Gynecology and Obstetrics Post Graduation Program of Federal University of Paraná (UFPR) PR - Brazil.
Positivo University (UP). Curitiba - PR - Brazil.
出版信息
JBRA Assist Reprod. 2019 Oct 14;23(4):328-332. doi: 10.5935/1518-0557.20190014.
OBJECTIVE
This study aimed to identify which parameters positively affect the clinical pregnancy rates of IUI cycles and find which couples should opt for IUI.
METHODS
This retrospective observational study included 261 patients submitted to 381 IUI cycles with fresh or cryopreserved partner semen (IU-H) from January 2012 to February 2017 in a private center in Curitiba-PR, Brazil.
RESULTS
Idiopathic infertility was the most frequent finding (35.9%). Patients younger than 40 years accounted for 87.9% of the IUI cycles (n=335) and 16.1% of the clinical pregnancies (n=54). The pregnancy rate was three times higher in patients with an endometrium thickness ≥8 mm compared to patients with endometrium thickness <8mm. Sperm motility >55% was linked to higher pregnancy rates (p=0.002). Concerning gonadotropins, 159 (48.4%) took rFSH, 127 (38.7%) hMG, and 42 (12.8%) uFSH, with pregnancy rates of 21.3%, 10.4% and 10.5%, respectively.
CONCLUSION
Patients under 40 years of age with endometrium thickness ≥8 mm, sperm motility >55%, and on rFSH had significantly higher pregnancy rates (p<0.05).
目的
本研究旨在确定哪些参数对宫腔内人工授精（IUI）周期的临床妊娠率有积极影响，并找出哪些夫妇应选择IUI。
方法
这项回顾性观察研究纳入了2012年1月至2017年2月在巴西库里蒂巴市一家私立中心接受381个IUI周期治疗的261例患者，使用的是新鲜或冷冻保存的配偶精液（IU-H）。
结果
特发性不孕是最常见的情况（35.9%）。年龄小于40岁的患者占IUI周期的87.9%（n=335），占临床妊娠的16.1%（n=54）。与子宫内膜厚度<8mm的患者相比，子宫内膜厚度≥8mm的患者妊娠率高出三倍。精子活力>55%与较高的妊娠率相关（p=0.002）。关于促性腺激素，159例（48.4%）使用重组促卵泡素（rFSH），127例（38.7%）使用人绝经期促性腺激素（hMG），42例（12.8%）使用尿促卵泡素（uFSH），妊娠率分别为21.3%、10.4%和10.5%。
结论
年龄小于40岁、子宫内膜厚度≥8mm、精子活力>55%且使用rFSH的患者妊娠率显著更高（p<0.05）。
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