严重少弱精子症ICSI失败后改行供精人工授精的妊娠结局分析
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摘要
目的分析严重少弱精子症患者卵胞浆内单精子注射(ICSI)失败后改行供精人工授精(AID)的临床妊娠率(CPR)。方法回顾性分析因男方严重少弱精子症行ICSI助孕失败后改行AID助孕共114周期为研究组,同期选取因男方无精子症直接行AID助孕的416周期为对照组,比较两组妊娠结局并探究其影响因素。结果研究组的每周期CPR低于对照组(12.3%vs 24.8%),差异有统计学意义(P<0.05);研究组中的双次授精及促排卵周期每周期CPR均高于单次授精及自然周期治疗,差异有统计学意义(P<0.05);体质量指数(BMI)、不孕类型对CPR均无影响,差异无统计学意义。结论男方严重少弱精子症行ICSI助孕失败后改行AID助孕的每周期CPR低于对照组,促排卵能提高CPR。
Objective To investigate the clinical pregnancy rate(CPR) of artificial insemination with donor sperm(AID) after failure of intracytoplasmic sperm injection(ICSI) in patients with severe oligoasthenospermia.Methods The CPR of AID treatment(research group, n=114) after failure of ICSI in patients with severe oligoasthenospermia was retrospectively analysed, who was directly undergoing AID due to non-obstructive azoospermia during the same period as control group(control group,n=416), comparing the two groups of pregnancy outcomes and evaluating its influencing factors.Results The CPR per cycle of research group was significantly lower than control group(P<0.05). The CPR per cycle with double insemination and the ovulation induction cycle were significantly higher than that with single insemination and the natural cycle in the research group.The body mass index(BMI) and type of infertility in research group did not affect the CPR.Conclusion The CPR of AID after failure of ICSI in patients with severe oligoasthenospermia is lower than control group, ovulation induction can increase the CPR of AID.
Objective To investigate the clinical pregnancy rate(CPR) of artificial insemination with donor sperm(AID) after failure of intracytoplasmic sperm injection(ICSI) in patients with severe oligoasthenospermia.Methods The CPR of AID treatment(research group, n=114) after failure of ICSI in patients with severe oligoasthenospermia was retrospectively analysed, who was directly undergoing AID due to non-obstructive azoospermia during the same period as control group(control group,n=416), comparing the two groups of pregnancy outcomes and evaluating its influencing factors.Results The CPR per cycle of research group was significantly lower than control group(P<0.05). The CPR per cycle with double insemination and the ovulation induction cycle were significantly higher than that with single insemination and the natural cycle in the research group.The body mass index(BMI) and type of infertility in research group did not affect the CPR.Conclusion The CPR of AID after failure of ICSI in patients with severe oligoasthenospermia is lower than control group, ovulation induction can increase the CPR of AID.
引文
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[13] Huang S,Wang R,Li R,et al.Ovarian stimulation in infertile women treated with the use of intrauterine insemination:a cohort study from China[J].Fertil Steril,2018,109(5):872-8.
[14] Zahiri S Z,Rashid S R,Pourmarzi D.Single versus double intrauterine insemination in controlled ovarian hyperstimulation cycles:a randomized trial[J].Arch Iran Med,2016,19(7):465-9.
[2] Kop P A,Mochtar M H,O'Brien P A,et al.Intrauterine insemination versus intracervical insemination in donor sperm treatment[J].Cochrane Database Syst Rev,2018,1:CD000317.
[3] Chen L,Zhu L,Cai C,et al.Clinical and neonatal outcomes of intrauterine insemination with frozen donor sperm[J].Syst Biol Reprod Med,2018,64(4):240-5.
[4] Huang D,Song S,Liao A.Short-term safety evaluation of the offspring conceived by 7272 artificial insemination cycles with donor spermatozoon[J].Andrologia,2016,48(7):817-23.
[5] Guan H T,Zheng Y,Wang J J,et al.Relationship between donor sperm parameters and pregnancy outcome after intrauterine insemination:analysis of 2821 cycles in 1355 couples[J].Andrologia,2016,48(1):29-36.
[6] Osaikhuwuomwan J,Osemwenkha A,Iribhogbe O,et al.The effect of female age on the outcome of intrauterine insemination treatment in a public hospital-assisted reproduction technology unit[J].Niger J Clin Pract,2018,21(8):988-92.
[7] Merviel P,Heraud M H,Grenier N,et al.Predictive factors for pregnancy after intrauterine insemination (IUI):an analysis of 1038 cycles and a review of the literature[J].Fertil Steril,2010,93(1):79-88.
[8] 刘莹,刘新宇,王冰松,等.供精人工授精妊娠结局的影响因素及子代安全性分析[J].中华男科学杂志,2016,22(3):229-32.
[9] Huyghe S,Verest A,Thijssen A,et al.Influence of BMI and smoking on IUI outcome with partner and donor sperm[J].Facts Views Vis Obgyn,2017,9(2):93-100.
[10] McCormack G R,Blackstaffe A,Nettel-Aguirre A,et al.The independent associations between Walk Score((R)) and neighborhood socioeconomic status,waist circumference,Waist-To-Hip ratio and body mass index among urban adults[J].Int J Environ Res Public Health,2018,15(6).pill:E1226
[11] Thijssen A,Creemers A,Van der Elst W,et al.Predictive factors influencing pregnancy rates after intrauterine insemination with frozen donor semen:a prospective cohort study[J].Reprod Biomed Online,2017,34(6):590-7.
[12] De Brucker M,Haentjens P,Evenepoel J,et al.Cumulative delivery rates in different age groups after artificial insemination with donor sperm[J].Hum Reprod,2009,24(8):1891-9.
[13] Huang S,Wang R,Li R,et al.Ovarian stimulation in infertile women treated with the use of intrauterine insemination:a cohort study from China[J].Fertil Steril,2018,109(5):872-8.
[14] Zahiri S Z,Rashid S R,Pourmarzi D.Single versus double intrauterine insemination in controlled ovarian hyperstimulation cycles:a randomized trial[J].Arch Iran Med,2016,19(7):465-9.