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目的了解促排卵在不同病因患者中对宫腔内人工授精妊娠结局的影响,旨在更合理有效的应用促排卵技术,指导临床治疗。方法回顾性分析我中心2011年5月至2012年10月期间5167个宫腔内人工授精治疗周期,按不孕的原因将其分为少弱精子症组,多囊卵巢综合征组,不明原因不孕组,宫颈因素组,性功能障碍组,卵巢功能减退组,分别比较各病因组中促排卵及自然周期的宫腔内人工授精妊娠结局,了解其对妊娠结局的影响。结果在少弱精子症组、多囊卵巢综合征组、不明原因不孕组促排卵周期临床妊娠率高于自然周期,差异有统计学意义,多胎率高于自然周期但差异不具有显著性,流产率及宫外孕发生率差异无显著性。而在宫颈因素组,性功能障碍组,卵巢功能减退组促排卵周期与自然周期组比较,临床妊娠率、流产率、多胎率及宫外孕发生率差异不具有统计学意义,无患者发生卵巢过度刺激。结论促排卵可提高少弱精子症,多囊卵巢综合征及不明原因不孕导致的不孕症的临床妊娠率,使多胎率增加,对流产率、宫外孕发生率无明显影响。而对宫颈因素、性功能障碍、卵巢功能减退所致的不孕症的临床妊娠率、双胎率及宫外孕发生率均无明显影响。
Objective To understand the effect of ovulation induction on intrauterine pregnancy outcome in patients with different etiologies, aiming at more reasonable and effective application of ovulation induction technique to guide clinical treatment. Methods A retrospective analysis of 5167 intrauterine insemination period from May 2011 to October 2012 in our center was divided into oligo-asthenospermia group, polycystic ovary syndrome group and unexplained cause Infertility group, cervical factors group, sexual dysfunction group, ovarian dysfunction group, respectively, compared with the etiology of ovulation and natural cycle of intrauterine intrauterine pregnancy outcome, to understand the impact on pregnancy outcome. Results In the oligoasthenospermia group, polycystic ovary syndrome group and unexplained infertility group, the clinical pregnancy rate in the ovulation cycle was higher than that in the natural cycle, the difference was statistically significant, the multiple birth rate was higher than the natural cycle but the difference was not significant, Miscarriage rate and ectopic pregnancy incidence no significant difference. In the cervical factor group, sexual dysfunction group, ovarian dysfunction group ovulation cycle compared with the natural cycle group, the clinical pregnancy rate, abortion rate, multiple birth rate and the incidence of ectopic pregnancy was no statistically significant difference, no patients with ovarian hyperstimulation . Conclusions Ovulation promotion can improve the clinical pregnancy rate of infertility caused by oligoasthenospermia, polycystic ovary syndrome and unexplained infertility, increase the multiple birth rate and have no significant effect on the abortion rate and the incidence of ectopic pregnancy. However, there was no significant effect on clinical pregnancy rate, twins rate and ectopic pregnancy rate of infertility caused by cervical factors, sexual dysfunction and ovarian dysfunction.