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目的通过研究女性输卵管因素对夫精人工授精(IUI)妊娠成功率的影响,探讨输卵管异常的不孕症患者助孕方式的选择。方法统计2010年12月1日-2015年5月31日行IUI治疗的311例不孕症患者共557个周期,根据女方输卵管情况分为3组。A组80例,一侧或双侧输卵管通而不畅及单侧输卵管阻塞组;B组18例,双侧或单侧输卵管炎行腹腔镜下输卵管整形术;C组213例为对照组:双侧输卵管通畅。分别对3组不孕类型、年龄、治疗结局、IUI日处理后前向运动精子总数>5×106治疗周期的治疗结局及不同治疗方案的治疗结局进行比较。结果 3组女方年龄、不孕类型、IUI日处理后前向运动精子总数>5×106治疗周期临床妊娠率差异无统计学意义(P>0.05);A组临床妊娠率高于B组与C组(14.0%vs 10.3%,11.0%),但无统计学差异(P>0.05);A组与B组促排卵周期所占比例分别为45.0%、44.8%,明显高于C组的27.6%(P<0.05);A组促排卵周期临床妊娠率高于C组(P>0.05)。结论对于轻度输卵管异常且女方年龄较轻者,建议先行输卵管通畅侧IUI,必要时促排卵治疗3个周期,若不成功,再考虑转IVF助孕治疗。
Objective To study the influence of female fallopian tube factors on success rate of pregnancy induced by artificial insemination (IUI) and to explore the choice of methods of pregnancy-assisted pregnancy in patients with tubal abnormalities. Methods Statistics From December 1, 2010 to May 31, 2015, 311 infertility patients treated with IUI for a total of 557 cycles were divided into 3 groups according to the fallopian tube condition of the woman. A group of 80 cases, one or both sides of tubal obstruction and unilateral tubal obstruction group; B group 18 cases, bilateral or unilateral salpingitis underwent laparoscopic tubal plastic surgery; 213 cases of C group as control group: Unilateral tubal patency. Three types of infertility, age, treatment outcome, IUI day after the treatment of the total number of motile sperm> 5 106 treatment cycles and treatment outcomes of different treatment were compared. Results There was no significant difference in the clinical pregnancy rates among the three groups (P> 0.05). The clinical pregnancy rate in group A was higher than that in group B and C (14.0% vs 10.3%, 11.0%), but there was no significant difference (P> 0.05). The proportion of ovulation cycles in group A and group B was 45.0% and 44.8% respectively, significantly higher than that in group C (27.6% (P <0.05). The clinical pregnancy rate of ovulation induction in group A was higher than that in group C (P> 0.05). Conclusions For patients with mild tubal abnormality and younger women, it is recommended that IUI of tubal obstruction be unobstructed first and ovulation treatment of three cycles if necessary. If unsuccessful, IVF may be considered.