CAJ | 학술논문

目的：探讨影响男性因素不孕宫腔内人工授精（IUI）妊娠率的相关因素。方法对167对不孕夫妇以男性因素为指征IU I治疗的302个周期的男性因素、男女双方年龄、不孕年限、原发或继发不孕、输卵管因素、是否促排卵、IU I治疗周期数、处理后前向运动精子数与妊娠率的关系进行分析。结果男性因素不孕者 IU I累计临床妊娠率为24．0％（40/167），其中弱精子症、畸精子症、少弱畸精子症、性功能障碍或精浆异常者妊娠率分别为11．7％、14．5％、13．7％、13．8％（ P＞0．05）；女方年龄小于30岁、30～34岁、≥35岁者妊娠率分别为13．1％、12．3％、15．6％（ P＞0．05）；男方年龄小于35岁、≥35岁者妊娠率分别为12．1％、15．0％（ P＞0．05）；不孕年限小于3年、3～4年、≥5年者妊娠率呈下降趋势，分别为14．9％、12．7％、9．3％，但差异无统计学意义（ P＞0．05）；原发性、继发性不孕者妊娠率分别为13．2％、13．2％（ P＞0．05）；单侧、双侧输卵管通畅者妊娠率分别为16．5％、12．1％（ P＞0．05）；自然周期、促排卵周期妊娠率分别为10．6％、15．9％（ P＞0．05）。以处理后前向运动精子数5×106为界限，≥5×106者妊娠率14．8％，＜5×106者妊娠率2．6％，两组比较差异有统计学意义（P＜0．05）。而研究中将处理后前向运动精子总数分为小于或等于5×106，5×106～＜10×106，10×106～＜20×106，≥20×106共4组比较，妊娠率分别为2．6％、19．0％、15．5％、13．0％，差异无统计学意义（ P＞0．05）；IU I治疗周期数1、2、3的妊娠率分别为14．4％、11．1％、15．8％（ P＞0．05），IUI治疗周期数大于或等于4妊娠率为0。结论处理后前向运动精子数是影响男性因素不孕IUI临床妊娠率的重要因素；IU I治疗周期数与妊娠率有关，超过3周期IU I无法提高临床妊娠率。目的：探討影響男性因素不孕宮腔內人工授精（IUI）妊娠率的相關因素。方法對167對不孕伕婦以男性因素為指徵IU I治療的302箇週期的男性因素、男女雙方年齡、不孕年限、原髮或繼髮不孕、輸卵管因素、是否促排卵、IU I治療週期數、處理後前嚮運動精子數與妊娠率的關繫進行分析。結果男性因素不孕者 IU I纍計臨床妊娠率為24．0％（40/167），其中弱精子癥、畸精子癥、少弱畸精子癥、性功能障礙或精漿異常者妊娠率分彆為11．7％、14．5％、13．7％、13．8％（ P＞0．05）；女方年齡小于30歲、30～34歲、≥35歲者妊娠率分彆為13．1％、12．3％、15．6％（ P＞0．05）；男方年齡小于35歲、≥35歲者妊娠率分彆為12．1％、15．0％（ P＞0．05）；不孕年限小于3年、3～4年、≥5年者妊娠率呈下降趨勢，分彆為14．9％、12．7％、9．3％，但差異無統計學意義（ P＞0．05）；原髮性、繼髮性不孕者妊娠率分彆為13．2％、13．2％（ P＞0．05）；單側、雙側輸卵管通暢者妊娠率分彆為16．5％、12．1％（ P＞0．05）；自然週期、促排卵週期妊娠率分彆為10．6％、15．9％（ P＞0．05）。以處理後前嚮運動精子數5×106為界限，≥5×106者妊娠率14．8％，＜5×106者妊娠率2．6％，兩組比較差異有統計學意義（P＜0．05）。而研究中將處理後前嚮運動精子總數分為小于或等于5×106，5×106～＜10×106，10×106～＜20×106，≥20×106共4組比較，妊娠率分彆為2．6％、19．0％、15．5％、13．0％，差異無統計學意義（ P＞0．05）；IU I治療週期數1、2、3的妊娠率分彆為14．4％、11．1％、15．8％（ P＞0．05），IUI治療週期數大于或等于4妊娠率為0。結論處理後前嚮運動精子數是影響男性因素不孕IUI臨床妊娠率的重要因素；IU I治療週期數與妊娠率有關，超過3週期IU I無法提高臨床妊娠率。
목적：탐토영향남성인소불잉궁강내인공수정（IUI）임신솔적상관인소。방법대167대불잉부부이남성인소위지정IU I치료적302개주기적남성인소、남녀쌍방년령、불잉년한、원발혹계발불잉、수란관인소、시부촉배란、IU I치료주기수、처리후전향운동정자수여임신솔적관계진행분석。결과남성인소불잉자 IU I루계림상임신솔위24．0％（40/167），기중약정자증、기정자증、소약기정자증、성공능장애혹정장이상자임신솔분별위11．7％、14．5％、13．7％、13．8％（ P＞0．05）；녀방년령소우30세、30～34세、≥35세자임신솔분별위13．1％、12．3％、15．6％（ P＞0．05）；남방년령소우35세、≥35세자임신솔분별위12．1％、15．0％（ P＞0．05）；불잉년한소우3년、3～4년、≥5년자임신솔정하강추세，분별위14．9％、12．7％、9．3％，단차이무통계학의의（ P＞0．05）；원발성、계발성불잉자임신솔분별위13．2％、13．2％（ P＞0．05）；단측、쌍측수란관통창자임신솔분별위16．5％、12．1％（ P＞0．05）；자연주기、촉배란주기임신솔분별위10．6％、15．9％（ P＞0．05）。이처리후전향운동정자수5×106위계한，≥5×106자임신솔14．8％，＜5×106자임신솔2．6％，량조비교차이유통계학의의（P＜0．05）。이연구중장처리후전향운동정자총수분위소우혹등우5×106，5×106～＜10×106，10×106～＜20×106，≥20×106공4조비교，임신솔분별위2．6％、19．0％、15．5％、13．0％，차이무통계학의의（ P＞0．05）；IU I치료주기수1、2、3적임신솔분별위14．4％、11．1％、15．8％（ P＞0．05），IUI치료주기수대우혹등우4임신솔위0。결론처리후전향운동정자수시영향남성인소불잉IUI림상임신솔적중요인소；IU I치료주기수여임신솔유관，초과3주기IU I무법제고림상임신솔。
Objective To investigate the influencing factors of clinical pregnancy rate of male factor couples undergoing intrau-terine insemination(IUI) treatment .Methods 167 infertile couples in 302 cycles who underwent IUI treatment for male factors were collected .The correlation between pregnancy rate and following factors were analyzed :male factors ,couples'age ,duration of infertility ,primary or secondary infertility ,with or without tubal factors ,ovulation induction or not ,treatment cycles of IUI ,motility of sperm after proceeding .Results The total clinical pregnancy rate of the cases collected was 24 .0% (40/167) .The individual pregnancy rate of the different male factors were :athenospermia was 11 .7% ,teratospermia was 14 .5% ,oligoasthenotspermia was 13 .7% ,sexual dysfunction and abnormal seminal plasma was 13 .8% ,there were no significant differences (P>0 .05);The individu-al pregnancy rate compared with different female age were :less than 30 years old was 13 .1% ,between 30 and 34 years old was 12 .3% ,older than 35 years old was 15 .6% ,there were no significant differences(P>0 .05);The individual pregnancy rate com-pared with different duration of infertility were :less than 3 years was 14 .9% ,between 3 and 4 years was 12 .7% ,more than 5 years was 9 .3% ,even there were no significant differences(P>0 .05) ,it showed that there might be negative correlation between dura-tion of infertility and pregnancy rate ;Both of the pregnancy rate of primary infertility and secondary infertility were 13 .2% ,there were no significant differences(P>0 .05);The individual pregnancy rate compared with unilateral and bilateral tubal patency were :unilateral was 16 .5% ,bilateral was 12 .1% ,there were no significant differences(P>0 .05);The pregnancy rate of IUI with natural cycles was 10 .6% ,ovulation induction cycles was 15 .9% ,there were no significant differences(P>0 .05);The pregnancy rate of progressive sperm count after proceeding more than ≥5 × 106 was 14 .8% ,the count less than 5 × 106 was 2 .6% ,there were signifi-cant differences(P<0 .05) ,otherwise ,if progressive sperm count was divided into four groups ,less than 5 × 106 ,between 5 × 106 -<10 × 106 ,between 10 × 106 - <20 × 106 ,more than 20 × 106 ,the pregnancy rate respectively was 2 .6% ,19 .0% ,15 .5% ,13 .0% , there were no significant differences(P>0 .05) .The individual pregnancy rate compared by different treatment cycles were :first cy-cle was 14 .4% ,two cycles were 11 .1% ,three cycles were 15 .8% ,there were no significant differences (P> 0 .05) ,but totally reached to four or even more cycles the pregnancy rate was 0 .Conclusion Progressive sperm count after proceeding is the major effect factor of clinical pregnancy rate undergoing IUI treatment for male factors .Increasing the IUI treatment cycles to more than three times has no better effect on improving clinical pregnancy rate .