摘要
目的:探讨宫腔内人工授精(IUI)治疗子宫内膜异位症((EMS)不孕临床效果的影响因素.方法:收集2008年1月~2014年1月在本科就诊的100例EMS不孕患者205周期IUI资料,比较EMS生育指数(EFI)和IUI术前促性腺激素释放激素激动剂(GnRH-a)预处理(GnRH-a组112周期,非GnRH-a组93周期)及治疗方案[自然周期组11周期,促排卵周期组194周期;促性腺激素(Gn)组139周期,非Gn组55周期]对临床妊娠率的影响.结果:EFI≥9分的EMS不孕患者IUI妊娠周期率及累积妊娠率分别为21.1%和40.0%,显著高于EFI≤8分的患者(分别为9.3%和20.0%),差异均有统计学意义(P<0.05);自然周期组与促排卵周期组周期妊娠率分别为0和14.4%;GnRH-a组与非GnRH-a组周期妊娠率分别为16.1%和10.8%,差异无统计学意义(P>0.05);Gn组与非Gn组周期妊娠率分别为15.8%和10.9%,双胎妊娠率分别为13.6%和16.7%,差异均无统计学意义(P>0.05).结论:EFI≥9分的EMS不孕患者腹腔镜术后应积极采用IUI助孕治疗,IUI治疗前不建议使用GnRH-a等药物进行预处理,促排卵联合IUI可以提高患者的妊娠几率.
Objective:To explore the relative factors affecting the clinical pregnancy rate of intrauterine insemination (IUI) for the treatment of infertility caused by endometriosis.Methods:The clinical data of 100 endometriosis patients complicated with infertility undergoing 205 IUI cycles during Jan.2008 to Jan.2014 were analyzed.The influences of endometriosis fertility index (EFI),gonadotropin releasing hormone analogues (GnRH--a) and the different regimen for ovulation on the clinical pregnancy rate of IUI were investigated.Results:The clinical pregnancy rate and the cumulative pregnancy rate were 21.1% and 40.0% in patients with EFI≥9,significantly higher than those of patients with EFI≤8 (9.3% and 20.0%,respectively,P<0.05) ; The clinical pregnancy rate was 14.4% in ovarian stimulation cycles and 0 in natural cycles; The clinical pregnancy rates of patients receiving and no receiving GnRH-a therapy before IUI were 16.1% and 10.8 %,respectively (P>0.05); The clinical and twin pregnancy rates of patients with gonadotropin (Gn) ovulation were 15.8% and 13.6% respectively,which was 10.9% and 16.7% with other regimen for ovulation,showing no statistically significant differences (P all >0.05).Conclusions:The patients with EFI≥9 should receive IUI therapy after laparoscopic operation as soon as possible,GnRH-a pretreatment before IUI is not recommended,and the combination of ovulation and IUI could increase the pregnancy rate.
出处
《中国计划生育学杂志》
2014年第9期606-609,613,共5页
Chinese Journal of Family Planning
基金
广州市卫生局资助项目(20131A011019)