Huang Xuan, Sun Qin, Tang Xu, Li Meiling, Zhou Cheng, Cheng Xi, Yao Bing, Chen Li
Center of Reproductive Medicine, Jinling Hospital, Clinical School of Medical College, Nanjing University, Jiangsu, People's Republic of China.
J Hum Reprod Sci. 2023 Jan-Mar;16(1):42-49. doi: 10.4103/jhrs.jhrs_130_22.
Many factors were reported associated with the pregnancy rate of intrauterine insemination (IUI), which played key role is still debated.
The aim of this study was to explore related clinical pregnancy outcome factor in IUI cycles of non-male factor.
The clinical data of 1232 IUI cycles in 690 couples experiencing infertility who attended the Reproductive Center of Jinling Hospital between July 2015 and November 2021 were retrospectively analysed.
Female and male age, body mass index (BMI), anti-Müllerian hormone (AMH), male semen parameters before and after wash, endometrial thickness (EMT), artificial insemination timing and ovarian stimulation (OS) protocols were compared between the pregnant group and the non-pregnant group in order to explore any correlation.
Continuous variables were analysed using independent-samples -test, and Chi-square test was used for comparison of measurement data between the two groups. <0.05 was considered statistical significance.
There were statistically significant differences in female AMH, EMT and duration of OS between the two groups. The AMH was higher in the pregnant group than in the non-pregnant group ( < 0.01), the stimulated days was significantly longer ( < 0.05) and EMT was significantly greater ( < 0.01) in the pregnant group than in the non-pregnant group. Further analysis showed that when patients with IUI had the following conditions: AMH > 4.5 ng/ml, EMT between 8 and 12 mm and letrozole + human menopausal gonadotropin stimulation with higher clinical pregnancy. However, there were no differences between the pregnant group and the non-pregnant group amongst the female and male age, BMI, hormones on baseline and day of human chorionic gonadotrophin, number of ovulated oocytes, sperm parameters before and after wash, treatment protocols and the timing of IUI ( > 0.05). Furthermore, there were 240 couples who not pregnant received one or more cycles of fertilisation/intracytoplasmic sperm injection/ pre-implantation genetic technology treatment, and another 182 couples forgo follow-up treatment.
The results of the present study demonstrate that the clinical IUI pregnancy rate is correlated with the factors of female AMH, EMT and OS protocol; more studies and samples are necessary to evaluate whether other factors affect pregnancy rate.
许多因素被报道与宫腔内人工授精(IUI)的妊娠率相关,但其关键作用仍存在争议。
本研究旨在探讨非男性因素的IUI周期中相关的临床妊娠结局因素。
回顾性分析了2015年7月至2021年11月期间在金陵医院生殖中心就诊的690对不孕夫妇的1232个IUI周期的临床资料。
比较妊娠组和非妊娠组的男女年龄、体重指数(BMI)、抗苗勒管激素(AMH)、洗涤前后男性精液参数、子宫内膜厚度(EMT)、人工授精时间和卵巢刺激(OS)方案,以探讨是否存在相关性。
连续变量采用独立样本t检验分析,两组间计量资料比较采用卡方检验。P<0.05被认为具有统计学意义。
两组间女性AMH、EMT和OS持续时间存在统计学显著差异。妊娠组的AMH高于非妊娠组(P<0.01),妊娠组的刺激天数显著更长(P<0.05),EMT显著更大(P<0.01)。进一步分析表明,当IUI患者具备以下条件时:AMH>4.5 ng/ml、EMT在8至12 mm之间且采用来曲唑+人绝经期促性腺激素刺激时,临床妊娠率更高。然而,妊娠组和非妊娠组在男女年龄、BMI、基线和人绒毛膜促性腺激素日的激素水平、排卵卵母细胞数量、洗涤前后精子参数、治疗方案和IUI时间方面无差异(P>0.05)。此外,有240对未妊娠的夫妇接受了一个或多个周期的体外受精/卵胞浆内单精子注射/植入前基因技术治疗,另有182对夫妇放弃了后续治疗。
本研究结果表明,临床IUI妊娠率与女性AMH、EMT和OS方案因素相关;需要更多的研究和样本以评估其他因素是否影响妊娠率。