Moreau Jessika, Gatimel Nicolas, Simon Cynthia, Cohade Clémentine, Lesourd Florence, Parinaud Jean, Léandri Roger
Department of Reproductive Medicine, Toulouse University Hospital, Toulouse, France.
EA 3694 Human Fertility Research Group, Paul Sabatier University, Toulouse, France.
Eur J Obstet Gynecol Reprod Biol X. 2019 May 30;4:100058. doi: 10.1016/j.eurox.2019.100058. eCollection 2019 Oct.
Intra-uterine insemination (IUI) is widely used for different indications. The aim of the present study was to evaluate the efficiency of intra-uterine insemination as a function of indication and origin of the inseminated spermatozoa.
The retrospective study involved 827 first attempts of IUI in 827 couples between January 2011 and July 2017 in the Toulouse university hospital. Of these, 642 used fresh sperm from the husband, 40 frozen sperm from the husband and 145 frozen sperm from donors. The measured outcome parameter was live birth rate per attempt.
When comparing couples lacking functional gametes (due to male or female causes), to couples who could potentially conceive spontaneously, i.e. subfertile, the latter were found to have a significantly lower live birth rate (18% vs 26%; P < 0.05). Even when adjusted for demographic parameters, which differed significantly between the 2 groups (female age, percentage of women suffering from primary infertility, BMI, number of inseminated motile spermatozoa and stimulation duration), this difference remained statistically significant (OR = 0.639 [0.425-0.961]; P = 0.0316).
When compared to couples lacking functional gametes, subfertile couples have poor IUI outcomes, suggesting a hidden cause of infertility, despite no apparent differences in ovarian reserve, tubal potency, results of ovarian stimulation and normal conventional sperm parameters. Further studies are required to better characterise and identify this subgroup of women with poor IUI outcomes.
宫腔内人工授精（IUI）因不同适应证而被广泛应用。本研究的目的是评估宫腔内人工授精的效率，该效率是授精精子的适应证和来源的函数。
这项回顾性研究纳入了2011年1月至2017年7月在图卢兹大学医院接受首次IUI治疗的827对夫妇。其中，642对使用丈夫的新鲜精子，40对使用丈夫的冷冻精子，145对使用供体的冷冻精子。测量的结果参数是每次尝试的活产率。
将缺乏功能性配子（由于男性或女性原因）的夫妇与可能自然受孕的夫妇（即亚生育夫妇）进行比较时，发现后者的活产率显著较低（18%对26%；P<0.05）。即使对两组之间有显著差异的人口统计学参数进行调整（女性年龄、原发性不孕女性的百分比、BMI、授精活动精子数量和刺激持续时间），这种差异仍具有统计学意义（OR=0.639[0.425-0.961]；P=0.0316）。
与缺乏功能性配子的夫妇相比，亚生育夫妇的IUI结局较差，这表明存在潜在的不孕原因，尽管在卵巢储备、输卵管功能、卵巢刺激结果和常规精子参数正常方面没有明显差异。需要进一步研究以更好地表征和识别这一IUI结局较差的女性亚组。
