Hänggi W, Birkhäuser M H, Ledermann B, Brandenberger A W, Sieber A
Endokrinologische Abteilung, Universitäts-Frauenklinik Bern.
Geburtshilfe Frauenheilkd. 1993 Sep;53(9):635-40. doi: 10.1055/s-2007-1023601.
In a two-years period, we treated 58 infertile couples for a total of 213 cycles with artificial homologous insemination (AIH). We considered a indication for AIH low sperm quality or a pathological postcoital test (PCT). Couples with idiopathic infertility did not receive AIH. If possible, AIH was performed by intrauterine insemination (IUI), following concentration of the motile sperms by "swim-up" method. Out of 213 cycles "swim-up", preparation could not be done in 46 cases (21.6%) because the initial sperm quality was below technical limits (sperm count below 1 Mio/ml). Out of 58 treated couples 4 became pregnant during AIH therapy (7%) among, them 2 couples conceiving twice after spontaneous early abortion. The total pregnancy rate per cycle was 2.8%. In the cycles after "swim-up", the monthly pregnancy rate through IUI was 3.6%. In the presence of andrological factors was the pregnancy rate only 0.9% compared to 6.8% in cases of pathological PCT with normal sperm quality. Thus, it can be concluded, that IUI is not successful on the basis of low sperm quality. Only in cases of unfavourable cervical factor expressed by a pathological PCT accompanied with a normal spermiogramm, moderate success can be expected.
在两年时间里，我们对58对不孕夫妇进行了总共213个周期的人工同源授精（AIH）治疗。我们将AIH的指征定为精子质量低或性交后试验（PCT）异常。特发性不孕的夫妇未接受AIH治疗。如果可能，通过“上游”法浓缩活动精子后，采用宫腔内人工授精（IUI）进行AIH。在213个周期的“上游”准备中，有46例（21.6%）因初始精子质量低于技术限度（精子计数低于100万/ml）而无法进行。在58对接受治疗的夫妇中，有4对在AIH治疗期间怀孕（7%），其中2对夫妇在自然早期流产后再次受孕。每个周期的总妊娠率为2.8%。在“上游”后的周期中，通过IUI的每月妊娠率为3.6%。存在男性学因素时，妊娠率仅为0.9%，而精子质量正常的PCT异常病例的妊娠率为6.8%。因此，可以得出结论，基于低精子质量，IUI并不成功。只有在PCT异常且精子图谱正常所表示的不利宫颈因素的情况下，才有望取得适度成功。
