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目的:比较分析精子不同优选方法与宫腔内人工授精(IUI)成功率的相关性,以提高IUI妊娠率。方法:回顾性分析本院生殖中心门诊不孕症患者452例671个IUI周期,按精子优选方法分为3组:含5%人血清白蛋白(HSA)的Earle’s液上游法、SpermR inse上游法、SupraSperm密度梯度离心法。比较各组患者的处理前后精子密度与活动率及临床妊娠结局。结果:3种精子优选方法处理后精子活动率及a+b级精子百分率显著增加(P<0.01)。含5%HSA的Earle’s液上游法221个IUI周期,妊娠21个周期,周期临床妊娠率9.5%;SpermR inse上游法215个IUI周期,妊娠34个周期,周期临床妊娠率15.8%,与含5%HSA的Earle’s液上游法比较有显著性差异(P<0.05);SupraSperm密度梯度离心法235个IUI周期,妊娠34个周期,周期临床妊娠率14.5%,与含5%HSA的Earle’s液上游法比较无统计学差异(P>0.05)。结论:SpermR inse上游法的IUI临床妊娠率明显高于含5%HSA的Earle’s液上游法,适用于各类不孕症患者。SupraSperm密度梯度离心法也具有较高的周期临床妊娠率,洗涤效果好,操作便捷高效,尤其适用于含炎症细胞、死精子和畸形精子等不良成分较多的精液。
OBJECTIVE: To compare and analyze the correlation between different sperm preferred methods and success rate of intrauterine insemination (IUI) so as to improve the pregnancy rate of IUI. Methods: A retrospective analysis of 452 patients with 671 IUI cycles in the reproductive center outpatient infertility was divided into 3 groups according to the sperm preference method: Earle’s liquid upper method with 5% human serum albumin (HSA), SpermR inse upper method , SupraSperm density gradient centrifugation. The sperm density and activity rate before and after treatment and clinical pregnancy outcomes were compared between the groups. Results: The sperm motility and a + b sperm percentage increased significantly (P <0.01). 221 IUI cycles of Earle’s liquid with 5% HSA, 21 cycles of gestation and 9.5% of cycles of clinical pregnancy; 215 IUI cycles of SpermR inse upstream, 34 cycles of gestation, 15.8% of cycles of clinical pregnancy, (P <0.05). There were 235 cycles of IUI in SupraSperm density gradient centrifugation, 34 cycles of pregnancy and 14.5% of cycles of pregnancy. Earle’s liquid upstream assay with 5% HSA showed no significant difference No significant difference (P> 0.05). Conclusion: The clinical pregnancy rate of IUI with SpermR inse upstream method is obviously higher than that of Earle’s liquid with 5% HSA, which is suitable for all kinds of infertility patients. SupraSperm density gradient centrifugation also has a higher cycle clinical pregnancy rate, washing effect is good, convenient and efficient operation, especially for inflammatory cells, dead sperm and abnormal sperm and other undesirable components more semen.