摘要
目的分析胰岛素抵抗(IR)与多囊卵巢综合征(PCOS)不孕症患者宫腔内夫精人工授精(AIH)助孕临床妊娠率的关系。方法回顾分析2020年3月至2023年2月在苏州大学附属第二医院诊治的200例PCOS合并不孕症患者为研究对象,全部患者均接受AIH助孕,以AIH后4周时超声评估结果是否为临床妊娠进行分组,分为未妊娠组(133例)和妊娠组(67例)。根据200例患者IR发生情况,分为IR组和N-IR组。采用Logistic回归,分析PCOS不孕症患者AIH临床妊娠率的影响因素。结果未妊娠组≥35岁、肥胖、IR占比高于妊娠组,糖化血红蛋白(Hb A1c)水平高于妊娠组,窦卵泡计数(AFC)、血清抗苗勒管激素(AMH)、h CG日雌二醇(E2)水平、h CG日内膜厚度低于妊娠组(P<0.05)。构建Logistic回归模型,PCOS不孕症患者AIH助孕结局与年龄、肥胖、IR、h CG日内膜厚度、AFC、AMH、h CG日E2及Hb A1c有关(P<0.05)。结论PCOS不孕症患者AIH临床妊娠率与IR有关,IR是AIH未妊娠率增加的危险因素,降低IR对于提高AIH妊娠成功率具有一定的意义。
Objective To analyze the relationship between insulin resistance(IR)and clinical pregnancy rate of intrauterine insemination(AIH)with husband's sperm in infertility patients with polycystic ovary syndrome(PCOS).Methods Retrospective analysis of 200 PCOS patients with infertility who were diagnosed and treated in the Second Affiliated Hospital of Soochow University from March 2020 to February 2023.All patients received AIH assisted pregnancy.All patients received AIH assisted pregnancy,and were divided into two groups based on whether the ultrasound evaluation at 4 weeks after AIH was a clinical pregnancy:the non pregnancy group(133 cases)and the pregnancy group(67 cases).According to the occurrence of IR in 200 patients,they were divided into IR group and N-IR group.Logistic regression was used to analyze the influencing factors of AIH clinical pregnancy rate in patients with PCOS infertility.Results The non pregnancy group aged≥35 years old had a higher proportion of obesity and insulin resistance than the pregnancy group.The level of glycated hemoglobin(HbA1c)was higher than that of the pregnancy group,while the antral follicle count(AFC),serum anti Mullerian hormone(AMH),estradiol(E2)levels on hCG day,and endometrial thickness on hCG day were lower than those of the pregnancy group(P<0.05).Logistic regression model was constructed,the AIH assisted pregnancy outcomes of PCOS infertility patients were related to age,obesity,IR,hCG day endometrial thickness,AFC,AMH,E2,and HbA1c(P<0.05).Conclusions PCOS infertility patients'AIH clinical pregnancy rate is associated with IR.IR is a risk factor for increased AIH non-pregnancy rate.Improving IR status has clinical significance for enhancing AIH pregnancy success rate.
作者
周玲
吕芳
徐敏芹
董丹彤
倪婕
ZHOU Ling;LYU Fang;XU Minqin;DONG Dantong;NI Jie(Reproductive Medicine Center,the Second Hospital Affiliated Suzhou University,Suzhou Jiangsu 215000,China)
出处
《中国妇产科临床杂志》
北大核心
2025年第5期437-440,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
国家卫生健康委员会生殖健康药具重点实验室开放课题(KF2023-2)
苏州大学附属第二医院青年职工预研基金(SDFEYJLC2102)
苏州市体育局体育科研局管课题立项项目(TY2025-211)。
关键词
多囊卵巢综合征
不孕症
宫腔内夫精人工授精
胰岛素抵抗
polycystic ovary syndrome
infertility
intrauterine insemination with husband's sperm
insulin resistance
