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目的:探讨促排卵对不同病因不孕患者人工授精的影响。方法:回顾性分析因男性因素、输卵管盆腔因素、子宫内膜异位症(EMS)和不明原因进行人工授精患者的资料,根据患者进行自然周期或促排卵周期分组,比较不同周期组的临床妊娠率和活产率。采用多元回归分析模型校正患者年龄、不孕年限、不同因素构成比、基础FSH、LH、E_2、子宫内膜厚度、类型、宫腔内人工授精(IUI)日卵泡直径及男性前向运动精子总数。评估在男性因素、输卵管盆腔因素、EMS和不明原因中促排卵周期与临床妊娠率的关系。结果:①促排卵组患者平均年龄、不孕年限以及不孕因素构成比(男性因素、输卵管盆腔因素、EMS和不明原因)与自然周期比较,无统计学差异(P>0.05),而临床妊娠率和活产率均高于自然周期,但无统计学差异(P=0.08);②通过多元因素回归分析校正了年龄、基础内分泌水平、不孕因素、内膜厚度和类型及前向运动精子总数等混杂因素后,促排卵周期相对于自然周期依然有显著优势(OR=1.607;95%CI=1.115~2.316);③在不同因素不孕患者中,促排卵周期可提高输卵管盆腔因素患者的活产率(OR=4.56;95%CI=1.53~13.53)。结论:促排卵周期可提高输卵管盆腔因素患者宫腔内人工授精的临床妊娠和活产率。
Objective: To investigate the effect of ovulation induction on the artificial insemination of different causes of infertility. Methods: Retrospective analysis of male patients, tubal pelvic factors, endometriosis (EMS) and unexplained artificial insemination patients, according to the patient’s natural cycle or ovulation cycle grouping, comparing different cycles of clinical pregnancy Rate and live birth rate. The multiple regression analysis model was used to correct the age of patients, the duration of infertility, the composition ratio of different factors, the basal FSH, LH, E_2, the thickness of endometrium, the type of intrauterine insemination (IUI) follicle diameter and the number of male forward motility sperm . Evaluate the relationship between ovulation cycles and clinical pregnancy rates in men, tubal pelvic factors, EMS, and unexplained causes. Results: ① There was no significant difference in mean age, duration of infertility and constituent ratio of infertility (male factor, tubal pelvic factor, EMS and unexplained) compared with natural cycle in ovulation induction group (P> 0.05) Rate and live birth rate were higher than the natural cycle, but no statistical difference (P = 0.08); ②Multivariate regression analysis adjusted for age, basal endocrine levels, infertility, intima thickness and type and forward motility sperm (OR = 1.607; 95% CI = 1.115 ~ 2.316). ③Ovarian cycle in patients with different factors could increase the incidence of tubal pelvic factors Live birth rate (OR = 4.56; 95% CI = 1.53 ~ 13.53). Conclusions: Ovulation cycle can improve the clinical pregnancy and live birth rate of intrauterine insemination in tubal pelvic factors.