Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, São Paulo, Brazil.
Int J Gynaecol Obstet. 2019 Oct;147(1):65-72. doi: 10.1002/ijgo.12898. Epub 2019 Jul 23.
To evaluate prognostic factors for pregnancy after intrauterine insemination (IUI).
A retrospective study was conducted among couples who underwent IUI at Universidade de São Paulo, Brazil, between January 31, 2008, and April 30, 2016. The main outcome was a positive β human chorionic gonadotropin (β-hCG) test result after IUI. Univariate analyses were used to determine predictors of pregnancy. Selected numerical variables were categorized to maximize the area under the receiver operating characteristic (ROC) curve. Logistic regression was performed using the backward method. The quality of the model was evaluated using the R (Nagelkerke) and Hosmer-Lemeshow tests.
Of 355 insemination cycles, 56 (15.8%) resulted in a positive β-hCG test result. The predictors and cutoff values that maximized the area under the ROC curve were as follows: follicle-stimulating hormone (<7.7 mIU/mL; P<0.001); duration of infertility (<62 menses; P<0.001); number of follicles greater than or equal to 14 mm (>1 follicle; P<0.001); baseline spermatozoa concentration (>52.0 million/mL; P=0.007); total ejaculate (>123.7 million; P=0.003); and grade B motility (>35%; P=0.013). These factors were able to predict 50.4% of the positive test results (R ).
Prognostic factors for pregnancy identified approximately half of all successful outcomes after IUI.
评估宫腔内人工授精（IUI）后妊娠的预测因素。
本研究对 2008 年 1 月 31 日至 2016 年 4 月 30 日期间在巴西圣保罗大学接受 IUI 的夫妇进行了回顾性研究。主要结局是 IUI 后β人绒毛膜促性腺激素（β-hCG）检测呈阳性。采用单因素分析确定妊娠的预测因素。选择数值变量进行分类，以最大化受试者工作特征（ROC）曲线下的面积。使用向后法进行逻辑回归。使用 R（Nagelkerke）和 Hosmer-Lemeshow 检验评估模型的质量。
在 355 个授精周期中，有 56 个（15.8%）β-hCG 检测呈阳性。最大程度提高 ROC 曲线下面积的预测因素和截断值如下：卵泡刺激素（<7.7 mIU/mL；P<0.001）；不孕持续时间（<62 个月经周期；P<0.001）；≥14 mm 的卵泡数（>1 个卵泡；P<0.001）；基础精子浓度（>5200 万/mL；P=0.007）；总精液量（>12370 万；P=0.003）；B 级运动能力（>35%；P=0.013）。这些因素能够预测 50.4%的阳性检测结果（R ）。
确定的妊娠预测因素大约可以预测 IUI 后一半的成功妊娠结局。
