| Objective:To compare and analyze the clinical factors affecting the pregnancy outcomes of artificial insemination by husband,including infertility age,infertility years,body mass index(BMI),different endometrial treatment methods,different clinical treatment options,AIH cycle times,etc..In order to eliminate the adverse factors affecting pregnancy,instruct clinicians grasp the optimal timing of pregnancy and choose the appropriate protocol of infertility treatment,improve the pregnancy outcomes of infertile patientsMethods:3247 cycles infertile women receiving artificial insemination with husband's sperm(AIH)from the reproductive center of Jiangsu Subei People's Hospital from January 2011 to December 2017.The clinical data of 3247 cycles of infertile women receiving artificial insemination by Husband(AIH)from January 2011 to December 2017 at the reproductive center of Jiangsu Subei People's Hospital was selected as the research object.For the study subjects,the data was first divided into four groups according to the age of women:?25 years old,26?30 years old,31?35years old,>36 years old,as the female age ranged from 20 to 45 years old.Secondly,the data was divided into three groups according to the age of infertility:<2 Year,2-5 years and>5 years;according to the type of infertility,it is divided into primary infertility(2410 cycles)and secondary infertility(837 cycles).According to the cause of infertility,it was thirdly divided into male factors(1233 cycles),female factors(833 cycles),both factors(681 cycles),unexplained infertility(500 cycles).According to the World Health Organization's reference criteria for Asian women's BMI,infertile women can be divided into:low body weight group(BMI<18.5 kg/m2),normal body weight group(BMI:18.5?22.9kg/m2),overweight group(BMI:23.0?24.9 kg/m2),obese group(BMI? 25 kg/m2).The data was divided into three groups according to different endometrial thickness:(7mm,8?12mm and ?13mm.According to different treatment the program,it was divided into natural cycle(1857 cycles)and ovulation induction cycle(1390 cycles),and the later group was further divided into CC group,CC+HMG group,LE group,LE+HMG group and HMG group.According to different AIH cycle times,four groups:1st cycle group,2nd cycle group,3rd cycle group,?4th cycle group,were formed(The maximum number of AIH cycles in our hospital can reach eight cycles).Data analysis was used SPSS 16.0 statistical software.The data were described by mean,standard deviation and rate.Statistical analysis was performed by t-test and ?2 test.Result:in the total of 3247 cycles with AIH,there were 385 cycles received clinical pregnancy,including 8 cycles of multiple pregnancies(6 cycles for twins,2 cycles for triplets),11 cycles had ectopic pregnancy,and 112 cycles of spontaneous abortion.The total clinical pregnancy rate was 11.86%,the multiple pregnancy rate was 2.08%,the ectopic pregnancy rate was 3.07%,and the abortion rate was 29.09%.1.?2 test results showed that the clinical pregnancy rates of age ?25 years,26?30 years old,31?35 years old were 11.86%(60/506),12.69%(228/1797),11.29%(84/744),respectively.The clinical pregnancy rate was better than in the age group ?36years old 6.5%(13/200),the difference was meaningful(P<0.05);The abortion rate in the age group ?36 years old was significantly higher than ?25 years old group,which was statistically significant(P<0.05).2.?2 test results showed that the clinical pregnancy rate of infertility years<2 years group was 13.56%(46/1431),which was better than the infertility period>5 years group,the difference was statistically significant(P<0.05);There was no significant difference in abortion rate(P>0.05).3.?2 test results showed that the clinical pregnancy rate of normal body reorganization was 13.45%(258/1918),which was significantly higher than the clinical pregnancy rate of low body recombination,super recombination and obesity groups of 9.24%(22/238),10.15%(79/739),8.81%.(52/590),and there was a statistical difference(P<0.05);the abortion rate of the obese group was 44.23%(23/52),which was significantly higher than that of the normal body recombination 25.19%(65/258),(P<0.05).4.?2 test results showed that the clinical pregnancy rate of endometrial thickness 8-12mm group was 12.98%(269/2072),which was better than the clinical pregnancy rate of ?7mm and ?13mm group,respectively 10.11%(71/702),9.51%(43/473),statistically significant(P<0.05);the abortion rate of endometrial thickness ?7mm and?13mm were 42.25%(30/71)and 37.78%(17/45),respectively.The abortion rate was 24.16%(65/269),which was significantly higher than the endometrial thickness of 8-12 mm(P<0.05).5.The results of t test and ?2 test showed that the mean number of follicles in the former was significantly higher than that in the natural cycle of ovulation induction,(P<0.05).No statistical difference in clinical pregnancy rate and abortion rate between the two groups.But the multiple pregnancy rate(3.93%)of the ovulation cycle was obviously higher than the natural cycle(0.48%),(P<0.05).The clinical pregnancy rates of LE+HMG and CC+HMG in different ovulation induction programs were 16.91%and 16.55%,respectively,which were Significantly superior to the other three ovulation induction programs(P<0.05).The abortion rate of CC group was 43.75%(7/16),which was higher than that of LE+HMG group 17.78%(8/45),the difference was statistically significant(P<0.05).6.?2 test results showed that the clinical pregnancy rate of secondary infertile women was 14.46%(121/837),the clinical pregnancy rate was better than the primary infertile women,and the secondary infertility group abortion rate was significantly lower than the primary infertile women,the difference was statistically significant(P<0.05).7.?2 test results showed that among different causes,the clinical pregnancy rate of male factors group was 13.94%(172/1233),which was better than female infertility caused by both factors(P<0.05)and the abortion rate of the former was significantly lower than that of the latter group(P<0.05).8.?2 test results showed that the clinical pregnancy rate of the AIH cycle number over the fourth cycle group was 7.65%(14/183),which was significantly lower than the first cycle group(P<0.05).Conclusion:1.The pregnancy outcome of normal body weight group in artificial insemination patients was better than that in low body weight group,overweight group and obesity group.2.There was no significant difference between the pregnancy outcome between ovulation induction cycle and the natural cycle in artificial insemination patients,but the multiple pregnancy rate was higher in the ovulation induction cycle.The simple application of clomiphene could significantly increased the abortion rate of infertile women.CC/LE combined with HMG to promote ovulation could significantly improved pregnancy outcomes.3.Intra-insemination patients with endometrial thickness of 8?12mm can get a good pregnancy outcome,endometrial too thick or too thin are not conducive to pregnancy outcomes;4.The pregnancy outcomes in Intra-insemination patients with secondary infertility or simple male factors,are better than that of patients with primary infertility and other factors infertility patients.5.Increasing the times of AIH can gradually increase the cumulative pregnancy rate;the cycle pregnancy rate decreased with the increase of the times of AIH,among which the pregnancy outcome of first AIH was the highest,and the pregnancy rate was significantly decreased after AIH times ?4 times. |
PDF Full Text Request