Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, Sichuan, China.
Shandong Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
Eur J Med Res. 2023 Oct 5;28(1):402. doi: 10.1186/s40001-023-01377-z.
To date, there is no consensus on whether intrauterine insemination (IUI) treatment is required in young patients with diminished ovarian reserve (DOR). Pregnancy outcomes in young DOR patients undergoing IUI are controversial. The existing studies are all single-center studies, with no existing multicenter cohort studies. The purpose of this multicenter study was to investigate the pregnancy outcomes of young DOR patients undergoing IUI.
This multicenter cohort study included a total of 4600 cycles in 2204 infertile patients who underwent IUI treatment in three reproductive medical centers between September 2018 and January 2022. The research subjects were divided into two groups according to their serum anti-Müllerian hormone (AMH) levels. Propensity score matching (PSM) was used to match the research subjects at a ratio of 1:4. The pregnancy outcomes in the two groups were compared.
There was no significant difference in the clinical pregnancy rates (CPR), biochemical rates, and ectopic pregnancy rates between the two groups (P > 0.05). There were, however, significant differences in the miscarriage rates between the groups (P < 0.05). The live birth rates (LBR) were 6.6 vs. 9.9 between the two groups. The multivariable logistic regression models reveal that body mass index, AMH were significantly correlated with CPR; AMH were significantly correlated with LBR; BMI, follicle stimulating hormone were significantly correlated with miscarriage rate.
The clinical pregnancy rate of DOR patients was not significantly different from that of NOR patients; however, the miscarriage rates were significantly different from those of NOR patients.
迄今为止，对于卵巢储备功能降低（DOR）的年轻患者是否需要宫腔内人工授精（IUI）治疗尚无共识。接受 IUI 的年轻 DOR 患者的妊娠结局存在争议。现有的研究均为单中心研究，尚无多中心队列研究。本多中心研究旨在探讨年轻 DOR 患者接受 IUI 的妊娠结局。
这项多中心队列研究共纳入了 2204 名不孕患者的 4600 个周期，他们于 2018 年 9 月至 2022 年 1 月期间在三家生殖医学中心接受 IUI 治疗。研究对象根据血清抗苗勒管激素（AMH）水平分为两组。采用倾向评分匹配（PSM）按 1:4 的比例匹配研究对象。比较两组的妊娠结局。
两组的临床妊娠率（CPR）、生化妊娠率和异位妊娠率均无显著差异（P＞0.05）。但两组的流产率有显著差异（P＜0.05）。两组的活产率分别为 6.6%和 9.9%。多变量逻辑回归模型显示，体质量指数、AMH 与 CPR 显著相关；AMH 与 LBR 显著相关；BMI、卵泡刺激素与流产率显著相关。
DOR 患者的临床妊娠率与 NOR 患者无显著差异，但流产率与 NOR 患者有显著差异。
