目的 探讨夫精宫腔内人工授精(IUI)早期妊娠丢失发生的影响因素。 方法 回顾性分析2015年1月至2023年12月于我中心接受IUI助孕后HCG阳性的405对夫妇共426个周期的临床资料。根据妊娠情况分为早期妊娠丢失组（n=85）和继续妊娠组（n=341）。比较两组患者的基本情况、HCG日内膜厚度、男方精液情况等，并对早期妊娠丢失的相关因素进行单因素和多因素分析。 结果 本研究中所回顾周期的早期妊娠丢失率19.95%（85/426）。单因素分析发现，女方年龄、BMI、基础FSH、不孕年限、处理后精子总数、治疗方案、周期数、男方抽烟情况、精子正常形态率、禁欲天数、男方因素、PCOS和盆腔输卵管因素等没有统计学差异（P>0.05）；两组之间FSH/LH比值、不孕类型、HCG日子宫内膜厚度的差异有统计学意义（P<0.05）。多因素回归显示，FSH/LH比值（P<0.05）、不孕类型（P<0.05）、PCOS（P<0.05）是IUI早期妊娠丢失的独立影响因素。 结论 FSH/LH≥2，不孕类型和PCOS是宫腔内人工授精发生早期妊娠丢失的显著影响因素。
Abstract
Objective To investigate the factors influencing early pregnancy loss following husband intrauterine insemination (IUI). Methods A retrospective analysis was conducted on the clinical data of 426 IUI cycles from 405 couples who tested positive for HCG and received IUI treatment at our center between January 2015 and December 2023. Based on pregnancy outcomes, the patients were divided into two groups: the early pregnancy loss group (n=85) and the ongoing pregnancy group (n=341). Basic patient characteristics, endometrial thickness on the day of HCG administration, and semen parameters were compared between the two groups. Univariate and multivariate analyses were performed to identify factors associated with early pregnancy loss. Results The early pregnancy loss rate in the reviewed cycle was about 19.95% (85/426). Univariate analysis showed there were no significant differences in female age, BMI, basal FSH, duration of infertility, total motile sperm count after processing, treatment protocol, number of cycles, male smoking status, normal sperm morphology rate, duration of abstinence, male factors, PCOS, and pelvic tubal factors (P>0.05). There were significant differences in the FSH/LH ratio, type of infertility, and endometrial thickness on the day of HCG administration between the two groups (P<0.05). Multivariate regression indicated that FSH/LH ratio (P<0.05), type of infertility (P<0.05) and PCOS (P<0.05) were independent factors influencing early pregnancy loss in IUI. Conclusions FSH/LH ratio≥2, type of infertility, and PCOS are significant factors influencing early pregnancy loss in intrauterine insemination.
关键词
夫精人工授精 /
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早期妊娠丢失 /
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流产 /
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影响因素
Key words
Intrauterine insemination /
Early pregnancy loss /
Miscarriage /
Influencing factors
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