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首页> 外文期刊>International journal of fertility and women's medicine >Intrauterine insemination results in couples requiring extended semen transport time.
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Intrauterine insemination results in couples requiring extended semen transport time.

机译：宫内授精导致夫妇需要延长精液运输时间。

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摘要

PURPOSE: The purpose of the present study is to compare intrauterine insemination (IUI) pregnancy rates (PR) as a function of diagnosis and ovulation protocol utilizing an extended semen transport time. This allowed clients to conveniently collect IUI specimens in the comfort and privacy of their home. A single IUI per treatment cycle was performed. BASIC PROCEDURES: Three-hundred-ten consecutive infertilty couples having unexplained, male factor, ovulatory dysfunction, endometriosis, tubal factor or combined diagnostic factors receiving a total of 584 cycles of IUI were included. Ovulation protocols included LH surge, clomiphene citrate (CC)-hCG, CC-gonadotropins(Gn)-hCG, Gn-hCG or leuprolide acetate (L)-Gn-hCG followed 36-42 hours by a single IUI. Pregnancy rates per cycle (fecundity) and per couple (fertility) as a function of diagnosis, ovulation protocol and cycle number were evaluated. In each cycle the couples processed the specimen by adding sperm washing medium at room temperature to the specimen 30 min following collection and allowed it to incubate for two hours prior to IUI during transport. MAIN FINDINGS: Overall, fecundity was 11.8% (69/584) and fertility was 22.3% (69/310); respectively by diagnosis was: unexplained 22.6%, 38.8%; male factor 18.8%, 42.9%; ovulatory dysfunction 12.4, 22.6%; endometriosis 5.3%, 11.1%; tubal factor 7.6%,13.3%; and combined factors 9.7%, 20.0%. Unexplained vs endometriosis (P < 0.0001, P < 0.005), tubal factor (fecundity P < 0.008) and ovulatory dysfunction (fecundity P < 0.027) was statistically different. Male factor vs endometriosis (P < 0.011, P < 0.036) was significantly different. Ovulatory dysfunction vs endometriosis was significantly different (fecundity P < 0.027). Pregnancies by ovulation protocol: LH surge 4.5%,10.5%; CC-hCG 9.4%,14.9%; CC-Gn-hCG 13.7%, 23.7%; Gn-hCG 17.5%, 45.3%; L-Gn-hCG 3.5%, 6.7%. For Gn-hCG vs L-Gn-hCG (P < 0.009, P < 0.030) and LH surge (fecundity P < 0.033). CC-Gn-hCG vs CC-hCG (fertility P < 0.050) and L-Gn-hCG (P < 0.033, P < 0.034). Gn-hCG vs CC-hCG (fecundity P < 0.043). CONCLUSIONS: We conclude that IUI is effective when utilizing an extended transport time allowing most couples to collect the specimen at home and is most effective when utilizing Gn-hCG therapy. Based on our analysis, endometriosis, tubal factor and combined diagnostic categories should proceed earlier to higher level assisted reproductive technologies.
机译：目的：本研究的目的是利用延长的精液运输时间比较宫内授精（IUI）妊娠率（PR）与诊断和排卵协议的关系。这使客户可以在自己的家中舒适而私密地方便地采集IUI标本。每个治疗周期执行一次IUI。基本程序：包括三百例不明原因的男性不育夫妇，其男性原因，排卵功能障碍，子宫内膜异位，输卵管因素或综合诊断因素共接受584个IUI周期。排卵方案包括LH潮气，柠檬酸克罗米芬（CC）-hCG，CC-促性腺激素（Gn）-hCG，Gn-hCG或醋酸亮丙瑞林（L）-Gn-hCG，然后在36-42小时内加一次IUI。根据诊断，排卵协议和周期数，评估了每个周期（受精）和每对夫妇（受精）的妊娠率。在每个周期中，夫妇通过在收集后30分钟将室温下的精子洗涤介质添加到标本中来处理标本，并使其在IUI运送前孵育2小时。主要发现：总的来说，生育力为11.8％（69/584），生育力为22.3％（69/310）;通过诊断分别为：原因不明的22.6％，38.8％;男性因子18.8％，42.9％;排卵障碍12.4，22.6％;子宫内膜异位症5.3％，11.1％;输卵管因子7.6％，13.3％;和综合因素分别为9.7％，20.0％。子宫内膜异位症的原因不明（P <0.0001，P <0.005），输卵管因子（生殖力P <0.008）和排卵功能障碍（生殖力P <0.027）在统计学上是不同的。男性因素与子宫内膜异位症之间的差异有统计学意义（P <0.011，P <0.036）。排卵功能障碍与子宫内膜异位明显不同（生殖力P <0.027）。通过排卵协议怀孕：LH激增4.5％，10.5％; CC-hCG 9.4％，14.9％; CC-Gn-hCG 13.7％，23.7％; Gn-hCG 17.5％，45.3％; L-Gn-hCG 3.5％，6.7％。对于Gn-hCG与L-Gn-hCG（P <0.009，P <0.030）和LH浪涌（生殖力P <0.033）。 CC-Gn-hCG与CC-hCG（生育力P <0.050）和L-Gn-hCG（P <0.033，P <0.034）。 Gn-hCG vs CC-hCG（繁殖力P <0.043）。结论：我们得出结论，当使用延长的运输时间时，IUI是有效的，大多数夫妇可以在家中收集标本，而当使用Gn-hCG治疗时，IUI最为有效。根据我们的分析，子宫内膜异位，输卵管因素和综合诊断类别应更早地发展到更高水平的辅助生殖技术。

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