Guzick D S, Carson S A, Coutifaris C, Overstreet J W, Factor-Litvak P, Steinkampf M P, Hill J A, Mastroianni L, Buster J E, Nakajima S T, Vogel D L, Canfield R E
University of Rochester, NY, USA.
N Engl J Med. 1999 Jan 21;340(3):177-83. doi: 10.1056/NEJM199901213400302.
Induction of superovulation with gonadotropins and intrauterine insemination are frequently used to treat infertility. We conducted a large, randomized, controlled clinical trial of these treatments.
We studied 932 couples in which the woman had no identifiable infertility factor and the man had motile sperm. The couples were randomly assigned to receive intracervical insemination, intrauterine insemination, superovulation and intracervical insemination, or superovulation and intrauterine insemination. Treatment continued for four cycles unless pregnancy was achieved.
The 231 couples in the group treated with superovulation and intrauterine insemination had a higher rate of pregnancy (33 percent) than the 234 couples in the intrauterine-insemination group (18 percent), the 234 couples in the group treated with superovulation and intracervical insemination (19 percent), or the 233 couples in the intracervical-insemination group (10 percent). Stratified, discrete-time Cox proportional-hazards analysis showed that the couples in the group treated with superovulation and intrauterine insemination were 3.2 times as likely to become pregnant as those in the intracervical-insemination group (95 percent confidence interval, 2.0 to 5.3) and 1.7 times as likely as those in the intrauterine-insemination group (95 percent confidence interval, 1.2 to 2.6). The couples in the intrauterine-insemination group and in the group treated with superovulation and intracervical insemination were nearly twice as likely to conceive as those in the intracervical-insemination group.
Among infertile couples, treatment with induction of superovulation and intrauterine insemination is three times as likely to result in pregnancy as is intracervical insemination and twice as likely to result in pregnancy as is treatment with either superovulation and intracervical insemination or intrauterine insemination alone.
使用促性腺激素诱导超排卵和宫内授精常用于治疗不孕症。我们对这些治疗方法进行了一项大型随机对照临床试验。
我们研究了932对夫妇，其中女方无明确不孕因素，男方精子具有活力。这些夫妇被随机分配接受宫颈内授精、宫内授精、超排卵加宫颈内授精或超排卵加宫内授精。治疗持续四个周期，除非受孕。
接受超排卵加宫内授精治疗的231对夫妇的妊娠率（33%）高于宫内授精组的234对夫妇（18%）、接受超排卵加宫颈内授精治疗的234对夫妇（19%）或宫颈内授精组的233对夫妇（10%）。分层离散时间Cox比例风险分析表明，接受超排卵加宫内授精治疗的夫妇怀孕的可能性是宫颈内授精组夫妇的3.2倍（95%置信区间为2.0至5.3），是宫内授精组夫妇的1.7倍（95%置信区间为1.2至2.6）。宫内授精组和接受超排卵加宫颈内授精治疗组的夫妇受孕的可能性几乎是宫颈内授精组夫妇的两倍。
在不孕夫妇中，超排卵加宫内授精治疗导致妊娠的可能性是宫颈内授精的三倍，是超排卵加宫颈内授精或单独宫内授精治疗的两倍。
