目的:宫腔内人工授精(IUI)是最常见的辅助生殖治疗方法。然而,与其他治疗方法相比,它的成功率较低。因此,确定有助于IUI成功的因素尤其令人感兴趣,这就是本前瞻性研究的目的.
方法:在本研究中,仅包括具有新鲜精液样本的同源授精。所有女性均接受柠檬酸克罗米芬和促性腺激素的轻度卵巢刺激。在IUI之前,基本精液分析,DNA片段化指数(DFI)评估,以及精子氧化还原电位的测量,对每个精液样本进行。用密度梯度离心处理精液,并将500μl处理的精子用于授精。
结果:在200个循环中,有36次怀孕,其中六个是异位。持续怀孕的周期的特征是年轻的男性和女性年龄和更多的卵泡。多因素logistic回归分析显示,仅女性年龄与持续妊娠显着相关。DFI与男性年龄呈正相关,与精子浓度和进行性运动性呈负相关。精液氧化还原电位与精子浓度呈显著负相关,与DFI呈显著正相关。
结论:女性年龄似乎是在使用新鲜精液的同源IUI周期中实现持续妊娠的最重要决定因素。
OBJECTIVE: Intrauterine insemination (IUI) is the most common assisted-reproduction treatment. However, it has lower success rate in comparison to other treatments. Therefore, determining factors that contribute to IUI success is of particular interest and this was the purpose of this prospective study.
METHODS: In this study, only homologous inseminations with fresh semen samples were included. All women received mild ovarian stimulation with clomiphene citrate and gonadotropins. Before IUI, basic semen analysis, evaluation of DNA fragmentation index (DFI), as well as measurement of sperm redox potential, were performed on each semen sample. Semen was processed with density-gradient centrifugation and 500 μl of processed sperm was used for insemination.
RESULTS: In 200 cycles, there were 36 pregnancies, six of them ectopic. Cycles with ongoing pregnancies were characterized by younger male and female age and higher number of follicles. Multivariate logistic regression analysis showed that only female age was significantly associated with ongoing pregnancy. DFI was positively correlated with male age and negatively correlated with sperm concentration and progressive motility. Semen redox potential showed a strong negative correlation with sperm concentration and positive correlation with DFI.
CONCLUSIONS: Female age seems to be the most important determinant factor for the achievement of an ongoing pregnancy in homologous IUI cycles with fresh semen.