Vekemans M, Englert Y, Camus M, de Maertelaer G
Hum Reprod. 1987 Feb;2(2):121-5. doi: 10.1093/oxfordjournals.humrep.a136495.
This retrospective study compares results of artificial insemination by donor (AID) and in-vitro fertilization (IVF) trials, and especially of IVF treatment with fresh donor spermatozoa in patients who were unsuccessfully treated on 18 occasions by AID using frozen semen. AID gives cumulative pregnancy rate of 54.6% after six trials. But after 18 trials, 22.4% of the patients were still not pregnant. Treating them with IVF gave a probability of pregnancy as good as in the other IVF patients, 53.9% after six trials. However, pregnancy loss rates differed resulting in cumulative normal pregnancy rates of 16.2% in AID cycles ranking from 19 to 24 compared with 41.8% when going to IVF. In 'ex-AID' women, significantly more follicles were punctured, but the number of oocytes obtained and fertilized, embryos replaced, and the incidence of pregnancy did not differ from the other patients. Considering separately the various infertility factors encountered in the patients, the pregnancy rates still did not differ between ex-AID women and the others. Changing from long-term failed AID to IVF is certainly acceptable and even more so with the newly introduced technique of trans-vaginal puncture. The female infertility factors involved in AID failure are corrected in IVF.
这项回顾性研究比较了供体人工授精（AID）和体外受精（IVF）试验的结果，特别是对那些使用冷冻精液经18次AID治疗均未成功的患者进行新鲜供体精子IVF治疗的结果。AID在6次试验后的累积妊娠率为54.6%。但在18次试验后，仍有22.4%的患者未怀孕。对他们进行IVF治疗，其妊娠概率与其他IVF患者相同，6次试验后的妊娠率为53.9%。然而，流产率有所不同，导致AID周期（第19至24次）的累积正常妊娠率为16.2%，而IVF时为41.8%。在“曾接受AID治疗的”女性中，穿刺的卵泡明显更多，但获得和受精的卵母细胞数量、移植的胚胎数量以及妊娠发生率与其他患者并无差异。分别考虑患者中遇到的各种不孕因素，曾接受AID治疗的女性与其他女性的妊娠率仍无差异。从长期失败的AID改为IVF当然是可以接受的，尤其是采用新引入的经阴道穿刺技术时。IVF纠正了导致AID失败的女性不孕因素。
