Luo Yumei, Wu Shunhong, Yuan Jingru, Zhou Hua, Zhong Yufang, Zhang Mimi, Li Qing, Xu Xia, Sun Xiaofang, Zhu Detu
Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Front Med (Lausanne). 2021 May 10;8:638560. doi: 10.3389/fmed.2021.638560. eCollection 2021.
To determine the independent prognostic factors and develop a multivariate logistic regression model for predicting successful pregnancy following artificial insemination by husband (AIH) in infertile Chinese couples. A total of 3,015 AIH cycles with superovulation from 1,853 infertile Chinese couples were retrospectively analyzed. The clinical characteristics and sperm parameters were compared between the pregnant and non-pregnant groups. Multivariate logistic regression analysis was performed to remove the confounding factors and create an equation to predict the successful pregnancy. Receiver operating characteristic (ROC) curves were constructed for evaluating the abilities for prognostic classification of the independent predictors and the equation. The overall pregnancy rate was 13.0%. The pregnancy rate of double intrauterine insemination (IUI) (18.9%) was significantly higher than that of single IUI (11.4%). The pregnancy rate of the stimulated cycle (14.4%) was significantly higher than that of the natural cycle (9.0%). The pregnancy rates of the age groups <40 years are ~3 times higher than that of the ≥40 years age group. Among sperm parameters, the influencing factors included straight-line velocity (VSL), sperm deformity index (SDI), and normal form rate (all < 0.05). A multivariate logistic regression equation was created based on the above influencing factors. ROC analysis showed that the prognostic power of the equation is better than those of individual predictors. Cycle treatment options, single/double IUI, female age, sperm VSL, SDI, and normal form rate could predict successful pregnancy following AIH in China. The multivariate logistic regression equation exhibited a greater value for prognostic classification than single predictors.
确定中国不孕夫妇行丈夫精液人工授精（AIH）后成功妊娠的独立预后因素并建立多因素逻辑回归模型。回顾性分析了1853对中国不孕夫妇的3015个AIH促排卵周期。比较了妊娠组和未妊娠组的临床特征及精子参数。进行多因素逻辑回归分析以去除混杂因素并建立预测成功妊娠的方程。绘制受试者工作特征（ROC）曲线以评估独立预测因素及方程的预后分类能力。总体妊娠率为13.0%。双宫腔内人工授精（IUI）的妊娠率（18.9%）显著高于单IUI（11.4%）。促排卵周期的妊娠率（14.4%）显著高于自然周期（9.0%）。年龄<40岁组的妊娠率约为≥40岁组的3倍。在精子参数中，影响因素包括直线速度（VSL）、精子畸形指数（SDI）和正常形态率（均P<0.05）。基于上述影响因素建立了多因素逻辑回归方程。ROC分析显示该方程的预后能力优于单个预测因素。周期治疗方案、单/双IUI、女性年龄、精子VSL、SDI和正常形态率可预测中国AIH后的成功妊娠。多因素逻辑回归方程在预后分类方面比单个预测因素具有更大的价值。
