生殖医学杂志2024，Vol.33Issue(1)：42-48,7.DOI:10.3969/j.issn.1004-3845.2024.01.007
不同治疗方案对卵巢储备功能正常年轻女性夫精人工授精妊娠结局的影响
Effect of different treatment protocols on pregnancy outcomes of AIH in young women with normal ovarian reserve function
摘要
Abstract
Objective:To investigate the effect of different treatment protocols on pregnancy outcomes of artificial insemination with husband sperm(AIH)in the women under 35 years old with normal ovarian reserve function. Methods:The clinical data of 3 024 AIH cycles in women under 35 years old with normal ovarian reserve function in our center from January 2015 to August 2021 were analyzed in this retrospective study.According to the treatment protocols,the patients were divided into 6 groups:natural cycle group(NC,n=380),clomiphene group(CC,n=57),CC combined with Gn group(CC+Gn,n=78),gonadotropin group(Gn,n=1 712),letrozole group(LE,n=430),and LE combined with Gn group(LE+Gn,n=367).The patients'general characteristics and pregnancy outcomes in each group were compared,and multivariate logistic regression was used to analyze the relevant factors that affect the clinical pregnancy rate and live birth rate of AIH. Results:In general comparison,there were significant differences in the number of cycles,body mass index(BMI),antral follicle count(AFC),basic FSH level,dominant follicle number and infertility factors among 6 groups(P＜0.05),but there were no significant differences in the woman's age,infertility years,infertility types and semen processing methods(P＞0.05).There were significant differences in clinical pregnancy rate and live birth rate among 6 groups(P＜0.05).The clinical pregnancy rate(20.7％ vs.9.5％)and live birth rate(16.3％ vs.7.4％)in the LE+Gn group were significantly higher than those in NC group(P＜0.05).There were no significant differences in abortion rate,ectopic pregnancy rate and multiple birth rate among 6 groups(P＞0.05).After adjusting confounding factors,multivariate logistic regression showed that LE combined with Gn protocol and dominant follicle number were all protective factors for clinical pregnancy and live birth(OR＞1,P＜0.05),whereas infertility duration was a risk factor for clinical pregnancy and live birth(OR＜1,P＜0.05). Conclusions:LE combined with Gn protocol significantly improves the clinical pregnancy rate and live birth rate of AIH,and it can be used as preferred protocol for AIH in the women under 35 years old with normal ovarian reserve function.关键词
宫腔内人工授精/治疗方案/年轻女性/临床妊娠率/活产率Key words
Intrauterine insemination/Treatment protocol/Young women/Clinical pregnancy rate/Live birth rate分类
医药卫生引用本文复制引用
贺玲,黄永汉,林静..不同治疗方案对卵巢储备功能正常年轻女性夫精人工授精妊娠结局的影响[J].生殖医学杂志,2024,33(1):42-48,7.基金项目
广东省医学科研基金(B2021112) （B2021112）
佛山市"十四五"医学高水平重点专科建设项目(FSGSP145020) （FSGSP145020）
