生殖医学杂志2025，Vol.34Issue(6)：749-756,8.DOI:10.3969/j.issn.1004-3845.2025.06.005
经AID助孕单胎活产后患者二孩生育情况及活产率影响因素分析
Analysis of fertility status and influencing factors of the live birth rate of a second child in patients with the first singleton live birth by artificial insemination with donor semen
摘要
Abstract
Objective:To explore the fertility status of patients who gave birth to their second child after achieving their first singleton live birth through artificial insemination with donor semen(AID)and the factors influencing the live birth rate. Methods:A retrospective analysis was conducted on the clinical data of patients who underwent AID for their first pregnancy and achieved a singleton live birth at the Clinical Medical Center of the National Research Institute for Family Planning from January 2010 to December 2020,and subsequently returned to the center for AID to conceive their second child by September 2024.The fertility status of these patients undergoing AID for their second child was investigated,and potential factors affecting the live birth rate of AID-conceived second children were analyzed. Results:A total of 160 patients returned for a second child,with a return rate of 13.91％.Analysis was conducted on 347 treatment cycles from 153 patients,with the majority of being from rural registered residence(73.20％)and having a junior high school education(39.87％).The gender ratio of first-child males to females was 0.55(55/99),with more girls than boys.About 50.33％of patients were aged not less than 30 and less than 35 years,56.21％of patients had a second-child conception interval not less than 2 and not more than 5 years,49.67％of patients used semen for the conception of their first child,while 50.33％did not.Outcomes of AID assisted conception for a second child showed that the clinical pregnancy rate of AID cycles for a second child was 27.09％(94/347),the abortion rate was 17.02％(16/94),the live birth rate was 22.48％(78/347),the live single birth rate was 98.72％(77/78),and the live twin birth rate was 1.28％(1/78).Analysis results of factors affecting the live birth rate in AID patients conceiving a second child showed that the live birth rate gradually decreased with increasing patient age.The live birth rate in women aged less than 30 years(34.33％)was significantly higher than those of women aged between not less than 30 and less than 35 years(21.23％)as well as between not less than 35 and less than 40 years(17.02％)(both P＜0.05),but there was no significant difference compared to the women aged not less than 40 years(14.29％)(P＞0.05).There were no significant differences in live birth rates between different intervals for conceiving a second child,whether the same semen as the first child was used,and between different strategies of ovulation induction as well as different surgical methods(all P＞0.05).The live birth rate in three AID cycles(8.93％)was significantly lower than that in one(26.14％),two(23.60％),and five or more cycles(31.25％)(P＜0.05). Conclusions:The patient's age is the main influencing factor of the live birth rate of the second child in AID.The time interval between two pregnancies,whether the same semen as that of the first child is used,the treatment regimen,and the surgical method do not affect the live birth rate of the second child conceived through AID.Considering the ethical particularities of donor-assisted fertilization,it is necessary to provide education and guidance to patients,and facilitate the use of the same semen for AID-assisted conception in second-child patients as for first-child patients.关键词
供精人工授精/二孩/活产/生育意愿Key words
Artificial insemination with donor semen/Second child/Live birth/Fertility intention分类
医药卫生引用本文复制引用
张蔚,张敏,张广志,陈娟..经AID助孕单胎活产后患者二孩生育情况及活产率影响因素分析[J].生殖医学杂志,2025,34(6):749-756,8.基金项目
中央级公益性科研院所基本科研业务费专项(2022GJZD0103) （2022GJZD0103）
