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目的:探讨不明原因不孕患者行宫腔内人工授精（IUI）助孕时，采用自然周期或不同促排卵周期等不同助孕方案对妊娠结局的影响。方法:回顾性分析2016年3月至2018年8月在大连市幼保健院行IUI助孕治疗的393例不明原因不孕患者（共934个周期）的临床资料。按是否促排卵治疗分为自然周期组402个周期；促排卵周期组532个周期，再按不同促排卵方案分为五个亚组，氯米芬（CC）亚组124个周期，来曲唑（LE）亚组107个周期，尿促性素（HMG）亚组87个周期，CC+HMG亚组103个周期，LE+HMG亚组111个周期。比较各组患者的妊娠结局。结果:促排卵周期组临床妊娠率和活产率明显高于自然周期组[14.10%（75/532）比9.20%（37/402）和11.28%（60/532）比7.21%（29/402）]，差异有统计学意义（n P0.05）。7个周期发生卵巢过度刺激综合征，均为CC + HMG亚组。LE亚组、HMG亚组、CC + HMG亚组和LE+HMG亚组临床妊娠率和活产率明显高于CC亚 组[11.21%（12/107）、13.79%（12/87）、16.50%（17/103）、21.62%（24/111）比8.06%（10/124）和7.48%（8/107）、11.49%（10/87）、13.59%（14/103）、20.72%（23/111）比4.03%（5/124）]，流产率明显低于CC亚组：3/12、1/12、2/17和1/24比5/10；HMG亚组、CC + HMG亚组和LE + HMG亚组临床妊娠率和活产率明显高于LE亚组，流产率明显低于LE亚组，差异有统计学意义（n P<0.05）。n 结论:对不明原因不孕患者行IUI助孕时，采用LE联合HMG促排卵方案治疗，可获得更为理想的妊娠结局。“,”Objective:To investigate the effect of different schemes of intrauterine insemination (IUI) on pregnancy outcome in patients with unexplained infertility.Methods:The clinical data of 393 cases (934 cycles) with unexplained infertility patients who underwent IUI from March 2016 to August 2018 in Dalian Maternal and Child Health Hospital were retrospectively analyzed. The patients were divided into natural cycle group (402 cycles) and promote ovulation cycle group (532 cycles). In promote ovulation cycle group, the patients were divided into clomiphene (CC) subgroup (124 cycles), letrozole (LE) subgroup (107 cycles), menotropins (HMG) subgroup (87 cycles), CC + HMG subgroup (103 cycles), LE + HMG subgroup (111 cycles). The pregnancy outcomes of each group were compared.Results:The clinical pregnancy rate and live birth rate in promote ovulation cycle group were significantly higher than those in natural cycle group: 14.10% (75/532) vs. 9.20% (37/402) and 11.28% (60/532) vs. 7.21% (29/402), and there were statistical differences (n P<0.05). There were no statistical differences in abortion rate, ectopic pregnancy rate and twin pregnancy rate between 2 groups (n P<0.05). Ovarian hyperstimulation syndrome occurred in 7 cycles, all of which were in CC + HMG subgroup. The clinical pregnancy rate and live birth rate in LE subgroup, HMG subgroup, CC + HMG subgroup and LE + HMG subgroup were significantly higher than those in CC subgroup: 11.21% (12/107), 13.79% (12/87), 16.50% (17/103), 21.62% (24/111) vs. 8.06% (10/124) and 7.48% (8/107), 11.49% (10/87), 13.59% (14/103) and 20.72% (23/111) vs. 4.03% (5/124), the abortion rate was significantly lower than that in CC subgroup: 3/12, 1/12, 2/17 and 1/24 vs. 5/10; the clinical pregnancy rate and live birth rate in HMG subgroup, CC + HMG subgroup and LE + HMG subgroup were significantly higher than those in LE subgroup, the abortion rate was significantly lower than that in LE subgroup, and there were statistical differences (n P<0.05).n Conclusions:When the patients with unexplained infertility are assisted by IUI, LE combined with HMG ovulation induction can achieve a better pregnancy outcome.