Check J H, Bollendorf A, Zaccardo M, Lurie D, Vetter B
University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, USA.
Arch Androl. 1995 Sep-Oct;35(2):135-41. doi: 10.3109/01485019508987864.
Intrauterine insemination (IUI) has been used for the treatment of various causes of infertility, including unexplained infertility, male factor, and cervical factor. Some centers frequently use superovulation combined with IUI. The study presented herein attempted to evaluate the efficacy of IUI without superovulation in cases where all causes of infertility other than cervical or male factors have been eliminated. However, in the case of poor or absent cervical mucus, the use of controlled ovarian hyperstimulation (COH) may obscure the actual importance of the IUI, since it is possible that the poor cervical mucus is related to poor timing, inadequate follicular maturation, or low estradiol levels, which if corrected will obviate the need for IUI. In this study IUI was targeted for 36-40 h following the sera luteinizing hormone surge. A total of 108 patients were enrolled in this study: 47 with male factor, 61 with cervical factor. Patients were followed for a maximum of three cycles unless a pregnancy occurred within 3 months of treatment. Comparison of pregnancy rates (PRs) were based on diagnosis. The cumulative PRs per cycle for each of the three cycles studied were as follows: cervical factor--19.7, 36.8, and 36.8%; male factor--12.8, 29.3, and 38.3%. Thus, PRs were comparable for both groups after three treatment cycles. These data demonstrate that IUI is an effective therapy for cervical and/or male factor, even without superovulation.
宫腔内人工授精（IUI）已被用于治疗各种原因引起的不孕症，包括不明原因不孕症、男性因素和宫颈因素。一些中心经常将超排卵与IUI联合使用。本文介绍的这项研究试图评估在排除宫颈或男性因素以外的所有不孕原因的情况下，不进行超排卵的IUI的疗效。然而，在宫颈黏液质量差或缺乏的情况下，使用控制性卵巢过度刺激（COH）可能会掩盖IUI的实际重要性，因为宫颈黏液质量差可能与时机不佳、卵泡成熟不足或雌二醇水平低有关，如果这些问题得到纠正，可能就不需要进行IUI了。在这项研究中，IUI在血清促黄体生成素激增后36 - 40小时进行。共有108名患者参与了这项研究：47名有男性因素，61名有宫颈因素。患者最多随访三个周期，除非在治疗后3个月内怀孕。妊娠率（PRs）的比较基于诊断。所研究的三个周期中每个周期的累积PRs如下：宫颈因素组分别为19.7%、36.8%和36.8%；男性因素组分别为12.8%、29.3%和38.3%。因此，经过三个治疗周期后，两组的PRs具有可比性。这些数据表明，即使不进行超排卵，IUI对于宫颈和/或男性因素来说也是一种有效的治疗方法。
