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目的:探讨体外受精-胚胎移植技术(IVF-ET)治疗多次宫腔内人工授精(IUI)失败患者的临床效果。方法;对2005年4月~2009年12月在湖北省妇幼保健院因接受2次以上IUI助孕失败后行IVF/ICSI助孕患者的相关资料进行回顾性分析。结果:①136例多次IUI失败后行IVF/ICSI助孕治疗,取卵周期共156周期,新鲜胚胎移植周期共146周期,临床妊娠72例,临床妊娠率49.32%。②转行IVF/ICSI助孕患者中,行IVF-ET者134例,其中18例受精失败,占13.43%;行ICSI者2例,无1例受精失败。③18例常规体外受精失败患者中,原发不孕12例,占66.67%;不孕年限≥5年者9例,占50.00%,补救ICSI治疗后未见妊娠。结论:IVF-ET是多次IUI助孕失败患者的有效治疗手段;部分患者在常规体外受精时存在受精障碍,ICSI治疗对常规受精障碍的患者是有效的;对于反复IUI助孕失败者结合不孕原因和年限等病史可考虑行短时受精联合早期补救性ICSI治疗,降低完全受精失败的风险。
Objective: To investigate the clinical effect of in vitro fertilization-embryo transfer (IVF-ET) on patients with failed multiple intrauterine insemination (IUI). Methods; From April 2005 to December 2009, we retrospectively analyzed the data of IVF / ICSI assisted pregnancy in Hubei Maternal and Child Health Hospital after receiving more than two IUI pregnancy failure. Results: (1) 136 cases of IVF / ICSI assisted pregnancy were performed after 136 cases of IVF / ICSI failed to complete IVF / ICSI. There were 146 cycles of fresh embryo transfer and 72 cases of clinical pregnancy. The clinical pregnancy rate was 49.32%. Among the IVF / ICSI-assisted pregnancies, 134 patients underwent IVF-ET, of which 18 failed to fertilize, accounting for 13.43%. Two patients underwent ICSI, none of whom underwent fertilization failure. Among the 18 patients with routine in vitro fertilization failure, 12 cases were primary infertility, accounting for 66.67%; 9 cases were infertility≥5 years, accounting for 50.00%. No pregnancy was found after ICSI treatment. Conclusion: IVF-ET is an effective treatment for patients with failed IUI pregnancy. Some patients have fertilization disorders during conventional in vitro fertilization. ICSI treatment is effective for patients with conventional fertilization disorders. For patients with failed IUI pregnancy failure, Causes of pregnancy and length of life history may consider short-term fertilization combined with early rescue ICSI treatment to reduce the risk of complete failure of fertilization.