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目的:探讨处理后前向运动的精子总数(post-wash total mobile sperm count,PTMC)对夫精宫腔内人工授精(intrauterine insemination,IUI)妊娠率的影响。方法:回顾性分析因男方因素行IUI治疗的不孕夫妇的数据,并比较了PTMC(3.0~9.9)×10~6(研究组)及PTMC≥10×10~6(对照组)患者的IUI妊娠率。结果:共纳入139例(274个周期)患者。其中研究组87个周期,平均PTMC为(6.2±1.7)×10~6,对照组187个周期,平均PTMC为(25.6±13.7)×10~6,组间周期妊娠率差异无统计学意义(P>0.05)。在139例患者中,有32例患者(55个周期)PTMC始终<10×10~6,83例患者(149个周期)PTMC始终≥10×10~6,在4个周期后患者的累积妊娠率(cumulative pregnancy rate,CPR)分别为15.6%(5/32)和25.3%(21/83),组间比较也无统计学差异(P>0.05)。在PTMC始终<10×10~6组,在第4周期没有妊娠发生。结论:对于因男方因素行辅助生殖技术助孕治疗的患者,即使PTMC<10×10~6也可以尝试IUI,并能获得较好的妊娠率,但对于反复PTMC<10×10~6患者,不建议患者多次反复尝试,在经过3次IUI后仍未孕者,可考虑行IVF助孕治疗。
Objective: To investigate the effect of post-wash total mobile sperm count (PTMC) on pregnancy rate in intrauterine insemination (IUI). Methods: The data of male infertile couples treated with IUI were retrospectively analyzed. The IUI of PTMC (3.0 ~ 9.9) × 10 ~ 6 (study group) and PTMC≥10 × 10 ~ 6 (control group) Pregnancy rate. Results: A total of 139 patients (274 cycles) were enrolled. The average PTMC of the study group was (6.2 ± 1.7) × 10 ~ 6 in 87 cycles, and the average PTMC was (25.6 ± 13.7) × 10 ~ 6 in the control group. There was no significant difference in the rate of pregnancy among the groups P> 0.05). Out of 139 patients, PTMC was consistently <10 × 10 ~ 6 in 32 patients (55 cycles), and PTMC was consistently ≥10 × 10 ~ 6 in 83 patients (149 cycles). After 4 cycles, the patient’s cumulative pregnancy The cumulative pregnancy rate (CPR) was 15.6% (5/32) and 25.3% (21/83) respectively. There was no significant difference between the two groups (P> 0.05). In PTMC always <10 × 10 ~ 6 groups, in the 4th cycle no pregnancy occurred. CONCLUSIONS: For those patients assisted by assisted reproductive technology for pregnancy, IUI can be tried even if PTMC <10 × 10 ~ 6, and a better pregnancy rate can be obtained. However, for patients with repeated PTMC <10 × 10 ~ 6, It is not recommended to repeatedly try the patient, after 3 IUI still not pregnant, may consider IVF pregnancy treatment.