使用冷冻供体精子进行宫腔内人工授精的成功率与女性年龄及排卵前卵泡数量有关。
Success of intrauterine insemination using cryopreserved donor sperm is related to the age of the woman and the number of preovulatory follicles.
作者信息
Pittrof R U, Shaker A, Dean N, Bekir J S, Campbell S, Tan S L
机构信息
London Women's Clinic, UK.
出版信息
J Assist Reprod Genet. 1996 Apr;13(4):310-4. doi: 10.1007/BF02070144.
OBJECTIVE
Our objective was to assess parameters associated with a successful outcome of intrauterine insemination (IUI) using cryopreserved donor sperm.
DESIGN
We analyzed 750 consecutive donor IUI cycles undertaken by 363 women in an assisted conception clinic. The main outcome measure was clinical pregnancy.
RESULTS
IUI was performed in 94.7% of the 750 IUI treatment cycles commenced and 180 clinical pregnancies occurred. The clinical pregnancy rate per cycle was 26.4%. The rate was significantly related to the patient's age (30.5% for age < or = 35 years and 18.1% for age > 35 years; P < 0.006) and whether there was one or more than one preovulatory follicles [20.9, 34.4, and 31.5% for one, two, and three or four follicles with a mean diameter of 14 or more mm at the time of human chorionic gonadotropin (hCG) administration; P = 0.006]. Two to four preovulatory follicles were present in 12.6% of the natural cycles, 43.6% of clomiphene citrate or tamoxifen, and 59.9% of gonadotropin stimulated cycles. The difference in the number of preovulatory follicles between stimulated and unstimulated cycles was highly significant (P < 0.0001). Pregnancy rates were 29.9% in gonadotropin-stimulated cycles, 23.6% in clomiphene citrate- or tamoxifen-stimulated cycles, 23.6% in clomiphene and 20.1% in unstimulated cycles. The difference in pregnancy rates between gonadotropin-stimulated and natural cycles was significant (P = 0.038). Cycle fecundity rates were not significantly affected by the number of previous treatment cycles, duration of infertility, gravidity and parity of the patient, presence of a spontaneous luteinizing hormone (LH) surge before the administration of hCG, or number of motile sperm in the insemination specimen.
CONCLUSIONS
Success of IUI using cryopreserved donor sperm is related to the age of the women and whether there is one or more than one preovulatory follicles.
目的
我们的目的是评估与使用冷冻供体精子进行宫内人工授精（IUI）成功结局相关的参数。
设计
我们分析了一家辅助生殖诊所中363名女性连续进行的750个供体IUI周期。主要结局指标是临床妊娠。
结果
在开始的750个IUI治疗周期中，94.7%进行了IUI，发生了180例临床妊娠。每个周期的临床妊娠率为26.4%。该比率与患者年龄显著相关（年龄≤35岁者为30.5%，年龄＞35岁者为18.1%；P＜0.006），以及是否有一个或多个排卵前卵泡[在注射人绒毛膜促性腺激素（hCG）时，一个、两个以及三个或四个平均直径≥14mm的卵泡的妊娠率分别为20.9%、34.4%和31.5%；P = 0.006]。在自然周期中，12.6%存在两个至四个排卵前卵泡；在枸橼酸氯米芬或他莫昔芬治疗周期中，43.6%存在；在促性腺激素刺激周期中，59.9%存在。刺激周期和未刺激周期之间排卵前卵泡数量的差异非常显著（P＜0.0001）。促性腺激素刺激周期的妊娠率为29.9%，枸橼酸氯米芬或他莫昔芬刺激周期为23.6%，枸橼酸氯米芬刺激周期为23.6%，未刺激周期为20.1%。促性腺激素刺激周期和自然周期之间的妊娠率差异显著（P = 0.038）。周期受孕率不受既往治疗周期数、不孕持续时间、患者的妊娠次数和产次、注射hCG前是否出现自发促黄体生成素（LH）峰或授精标本中活动精子数量的显著影响。
结论
使用冷冻供体精子进行IUI的成功与女性年龄以及是否有一个或多个排卵前卵泡有关。
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