Department of Reproductive Center, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
Curr Med Sci. 2020 Aug;40(4):767-772. doi: 10.1007/s11596-020-2242-9. Epub 2020 Aug 29.
The optimal assisted reproductive treatment strategy for infertile women with unilateral tubal obstruction remains uncertain. To investigate the role of intrauterine insemination (IUI) in the treatment of infertile women with unilateral tubal occlusion, the data of 148 couples were retrospectively collected and analyzed. Seventy-eight infertile women with unilateral occlusion diagnosed by hysterosalpingography (HSG) were categorized as the study group and 70 others with unexplained infertility as the control group. The study group was divided into a proximal occlusion subgroup and a mid-distal occlusion subgroup for further analysis. The main outcomes, namely the clinical pregnancy rate (CPR), ongoing pregnancy rate (OPR), and live birth rate (LBR) per cycle, were analyzed. Our results showed a tendency of lower CPR, OPR, and LBR in the study group than in the control group, without statistical significance. Further investigations revealed that the unilateral proximal occlusion subgroup had similar CPR, OPR, and LBR as the control group, while the unilateral mid-distal occlusion subgroup had significantly lower CPR (5.1% vs. 20.0%, P=0.035), OPR (5.1% vs. 20.0%, P=0.035), and LBR (5.1% vs. 20.0%, P=0.035) than the control group. In conclusion, the clinical outcomes of IUI were worse in patients with unilateral tubal occlusion than in those with unexplained infertility. This might be primarily caused by the worse outcome of patients with unilateral mid-distal tubal occlusion instead of proximal occlusion.
对于单侧输卵管阻塞的不孕女性，最佳辅助生殖治疗策略仍不确定。为了研究宫腔内人工授精（IUI）在治疗单侧输卵管阻塞性不孕中的作用，回顾性收集了 148 对夫妇的数据并进行了分析。78 例经子宫输卵管造影（HSG）诊断为单侧阻塞的不孕妇女被分为研究组，70 例不明原因不孕妇女为对照组。研究组进一步分为近端阻塞亚组和中远端阻塞亚组进行分析。主要结局指标为每个周期的临床妊娠率（CPR）、持续妊娠率（OPR）和活产率（LBR）。结果显示，研究组的 CPR、OPR 和 LBR 均有下降趋势，但无统计学意义。进一步研究发现，单侧近端阻塞亚组的 CPR、OPR 和 LBR 与对照组相似，而单侧中远端阻塞亚组的 CPR（5.1%比 20.0%，P=0.035）、OPR（5.1%比 20.0%，P=0.035）和 LBR（5.1%比 20.0%，P=0.035）均明显低于对照组。总之，与不明原因不孕患者相比，单侧输卵管阻塞患者的 IUI 临床结局更差。这可能主要是由于单侧中远端输卵管阻塞患者的结局较差，而不是近端阻塞所致。
