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대한생식의학회지 제25권 제2호 2010년
자궁강내 인공수정에 의한 임신율
홍산부인과 불임클리닉
홍정의, 이지삼 ,
Pregnancy Rate by Intrauterine Insemination(IUI) with Controlled Ovarian Hyperstimulation(COH)
Hong je, Lee js
The effectiveness of intrauterine insemination(IUI) combined with controlled ovarian hyperstimulation(COH) in the treatment of infertility with various etiologies was compared in a total of 152 cycles. Patients received a maximum of three IUI cycles for the treatment. Severe male(< 2 X 106 motile sperm) or age factor(> 39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac was seen on ultrasound. The overall clinical pregnancy rate was 7.9% per cycle(12/152) and 9.7% per patient(12/124). The pregnancy rates were 0% in unstimulated natural(0/18), 7.5% in CC(3/40), 8.2% in CC+hMG(4/49), 5.9% in GnRH-a ultrashort(1/17), 5.9% in GnRH-a long(1/17) and 27.3% in dual suppression cycles(3/11), respectively. The pregnancy rate was higher in dual suppression cycle than other stimulated cycles, but this was not significant. The multiple pregnancy rates were 25.0%(2 twins and 1 triplet). No patient developed ovarian hyperstimulation. Abortion rates were 66.7% in CC(2/3) and 100% in ultrashort cycles(1/1). The livebirth rate was 5.9% per cycle(9/152) and 7.3% per patient(9/124). There were no differences in age, duration of infertility, follicle size, total ampules of gonadotropins and days of stimulation between pregnant and non-pregnant groups. However, significant(P<0.05) differences were observed in the level of estradiol(E2) on the day of hCG injection(3,266.6¡¾214.2 vs 2,202.7¡¾139.4 pg/ml) and total motile sperm count (212.1¡¾63.4 vs 105.1¡¾9.9 X 106) in pregnant group than in non-pregnant group. These results suggest that IUI combined with successful ovarian stimulation tends to improve the chance of pregnancy as compared to IUI without COH and a total motile sperm count may be considered predictive of the success for pregnancy.
키워드 : Infertility, Controlled ovarian hyperstimulation, IUI, Pregnancy rate, Multiple pregnancy
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