Ovarian response to controlled ovarian stimulation (COS) is a core determinant of assisted reproductive technology (ART) success, with marked interindividual variability. Accurate and individualized prediction is essential to optimize treatment safety and efficacy. Traditional static predictors include age, BMI, AMH, AFC, FSH/LH ratio, and inhibin B. Recently, dynamic indices such as FORT, FOI, OSI, and ORPI have improved real time evaluation of ovarian responsiveness. Genetic polymorphisms, epigenetic regulation, and environmental exposures further modulate ovarian sensitivity to gonadotropins. This review proposes a novel Integrated Multi-dimensional Ovarian Response Prediction (IMORP) framework that combines static reserve, dynamic responsiveness, genetics, and environment to guide personalized COS. We grade evidence levels, critically appraise strengths and limitations of each marker, and provide a head to head comparison of dynamic indices. Future directions should integrate multi omics data and clinical parameters to develop molecularly driven predictive models, advancing ART from empirical practice to precision medicine.

Polycystic ovary syndrome (PCOS) affects 11%-13% of reproductive-aged women globally. However, the impacts of ambient oxidants [characterized by ozone (O3) and nitrogen dioxide (NO2)], fine particulate matter (PM2.5) and its components, and residential greenness, on the risk of PCOS and its clinical reproductive trajectory have not been studied. We conducted a retrospective cohort study from 2014 to 2025 (976 PCOS cases and 5271 controls), logistic regression estimated associations between PCOS risk and environmental exposures. Among PCOS patients, modified Poisson and Andersen-Gill models evaluated exposure impacts on a sequence of adverse pregnancy outcomes (APOs). Exposure to all assessed pollutants was associated with increased PCOS risk. Each 1 μg/m3 increase in oxidants was linked to higher odds of PCOS [odds ratio (OR): 1.07, 95% confidence interval (95% CI): 1.05-1.08], exceeding any individual component. Among PM2.5 components, black carbon demonstrated the strongest association with PCOS risk (OR: 1.66, 95% CI: 1.53-1.80). In contrast, higher residential greenness (per 0.005 unit increase in 100-m buffer normalized differential vegetation index) was protective against PCOS risk (OR: 0.96, 95% CI: 0.95-0.96). Among PCOS patient subcohort, both long- and short-term pollutant exposures were associated with increased APOs risks along the clinical reproductive trajectory. PM2.5 components' effects [hazard ratios (HRs): 1.01-3.63] exceeded those of total PM2.5 mass (HRs: 1.01-1.05). Briefly speaking, ambient oxidants and PM2.5 are key environmental risk factors for the development of PCOS and the adverse clinical trajectory. Residential greenness represents a modifiable, nature-based strategy to help mitigate the PCOS burden and improve reproductive health.

Poor Ovarian Response (POR) significantly impairs the success of Assisted Reproductive Technologies (ART). The specific roles of oxidants and fine particulate matter (PM2.5) on female fertility, especially those with POR, remain poorly understood. In this cohort study of 4920 women undergoing ART cycles, we investigated the associations between long-term pre-treatment exposure to oxidants, PM2.5, their constituents, and six key reproductive outcomes. Results revealed that elevated oxidants exposure increased risks of pregnancy failure (for each 10 mu g/m3 increase in oxidants, odds ratios [OR]=1.238, 95%CI: 1.158, 1.325) and live birth failure (OR=1.330, 95%CI: 1.245, 1.420), with ozone identified as the primary contributor. Exposure to PM2.5 was significantly linked to an increased risk of POR (for each 10 mu g/m3 increase in PM2.5 exposure, OR=1.249, 95% CI: 1.205, 1.299), with organic matter (OM) being the key constituent. Crucially, residential greenness exerted significant protective effect, associated with reduced risks, accounting for 7.44%-17.72% of the observed associations between pollutants and adverse reproductive outcomes through the pathway of reducing oxidants and PM2.5. These findings highlight oxidants and PM2.5 as modifiable risk factors in the fertility equation, and emphasize residential greenness as a potential strategic nature-based intervention to mitigate pollution-related fertility impairment.

Polycystic ovary syndrome (PCOS) is a common reproductive, endocrine, and metabolic disorder in women of reproductive age, characterized by hyperandrogenemia, insulin resistance, and ovulatory dysfunction. Autophagy, a key cellular homeostasis mechanism, closely interacts with immune-inflammatory responses to drive PCOS pathogenesis. This review highlights the “liver-adipose-ovary circuit”—a pathological network where the liver, adipose tissue, and ovaries crosstalk via autophagy dysregulation, chronic low-grade inflammation, and metabolic disturbances. Abnormal autophagy in adipose tissue induces insulin resistance and inflammatory cytokine release; hepatic autophagy impairment exacerbates non-alcoholic fatty liver disease (NAFLD) and hyperandrogenemia; ovarian autophagy dysfunction disrupts folliculogenesis. These organ-specific abnormalities form a self-reinforcing cycle that amplifies PCOS phenotypes. Clinical therapies targeting this circuit (e.g., quercetin, metformin) show promise by regulating autophagy, improving insulin sensitivity, and restoring reproductive-metabolic balance. Future research should clarify inter-organ molecular mediators and validate autophagy-targeted strategies to advance personalized PCOS treatment.

Objective:The aim of this study is to assess the impact of different embryo transfer strategies, focusing on cleavage-stage embryos and blastocysts, on pregnancy and neonatal outcomes in frozen-thawed embryo transfer (FET) cycles among women < 35 years old and ≥ 35 years old. Methods:A retrospective cohort analysis of 3,065 FET cycles performed between April 2015 and October 2022 categorized patients into seven groups by embryo morphology, quality, and quantity: single/double high-quality cleavage (A/B), single/double high-quality blastocyst (C/D), single/double poor-quality blastocyst (E/F), and mixed-quality blastocyst (G). Stratified by age (<35/≥35 years), outcomes (clinical pregnancy, live birth, multiple pregnancy, preterm birth) were analyzed using non-parametric tests and chi-square. Results:In women <35 years, transferring two high-quality cleavage embryos (Group B) yielded higher clinical pregnancy (60.12% vs 28.57%) and live birth rates (51.45% vs 19.64%) than single high-quality cleavage embryos (Group A; P < 0.05). For blastocyst transfer, double high-quality blastocysts (Group D) showed higher multiple pregnancy and preterm birth rates than single high-quality blastocysts (Group C; P < 0.05). In women ≥35 years, Group B had superior pregnancy outcomes compared to Group A, while Group D demonstrated significantly higher clinical pregnancy and live birth rates than Group C (P < 0.05). Transferring two poor-quality blastocysts (Group F) improved live birth rates in older patients compared to single poor-quality blastocysts (Group E; 31.91% vs 14.29%, P < 0.05). No significant differences in neonatal birth weight were observed across age groups. Conclusion:For FET cycles, transferring two high-quality cleavage embryos is recommended for all ages. Women <35 years should prioritize single high-quality blastocyst transfer to minimize multiple pregnancies and preterm births, while those ≥35 years benefit from double high-quality blastocysts. Transferring two poor-quality blastocysts may enhance pregnancy outcomes in older patients. These findings warrant validation through multicenter studies to ensure clinical applicability.

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine and metabolic disorder among women of reproductive age. Although the traditional mechanistic framework has focused on dysregulation of the hypothalamic-pituitary-ovarian axis (HPOA), emerging evidence suggests that PCOS-associated metabolic disturbances predominantly originate from dysregulation of the hypothalamic-sympathetic nerve-adipose tissue axis (HSF axis). This article systematically reviews the mechanisms by which hypothalamic nuclei (including the arcuate nucleus and paraventricular nucleus) regulate adipose tissue metabolism through sympathetic neural pathways. Furthermore, it explores how HSF axis dysfunction exacerbates both metabolic and reproductive abnormalities in PCOS through pathophysiological pathways such as chronic low-grade inflammation and energy sensing dysregulation. This synthesis offers novel insights into PCOS pathogenesis by bridging the gap between neuroendocrine regulation and systemic metabolic dysfunction.

Polycystic ovary syndrome (PCOS) is a prevalent gynecologic endocrine disorder characterized by menstrual irregularities, elevated androgen levels, and ovulatory dysfunction. Its etiology is multifactorial. Emerging evidence indicates that PCOS patients exhibit diminished gut microbiota (GM) diversity and altered microbial ratios, contributing to the metabolic derangements observed in these individuals. This review elucidates the role of GM in the pathogenesis and metabolic disorders of PCOS, encompassing insulin resistance (IR), hormonal imbalances, bile acid metabolic disorders, Interleukin-22-mediated immune dysregulation, and brain-gut axis disturbances. Additionally, it synthesizes current therapeutic strategies targeting the GM, aiming to furnish a theoretical framework for prospective clinical interventions.

BackgroundAlthough immune checkpoint inhibitors (ICIs) represent a substantial breakthrough in cancer treatment, it is crucial to acknowledge that their efficacy is limited to a subset of patients. The heterogeneity and stemness of cancer render its response to immunotherapy variable, warranting the identification of robust biomarkers for evaluation.MethodsPublicly available Ovarian Cancer (OV) single-cell RNA (scRNA) sequence dataset was collected and analyzed to elucidate the intrinsic driver gene of OV cancer cells. Through genome-scale CRISPR screening of RNA sequencing data from Project Achilles, essential genes specific to OV were identified. A novel cancer stem cell index (CSCI) was developed and validated using multiple advanced algorithms and large-scale datasets, as well as corresponding clinical features, including 14 OV transcriptomic datasets, 7 pan-cancer ICI transcriptomic cohorts and one melanoma scRNA dataset derived from PD-1 treated patients.ResultsChromosomal 20q gain, 8q gain, and 5q loss have been identified as ovarian cancer-specific driving variations. By analyzing large-scale datasets of ovarian cancer transcriptomics, including scRNA and CRISPR cell line datasets, we have identified a gene set that influences tumor intrinsic drivers and stemness properties. We then developed the CSCI to predict the prognosis and response to immunotherapy in ovarian cancer patients using advanced machine learning algorithms. When applied to PD1/PD-L1 ICI transcriptomic cohorts, CSCI consistently and accurately predicts tumor progression and immunotherapy benefits, with a mean AUC greater than 0.8. Notably, compared to previously established signatures, CSCI demonstrates better predictive performance across multiple ovarian cancer datasets. Intriguingly, we discovered that amplification of CSE1L enhances the stemness of tumor-initiating cells, facilitates angiogenesis, and the formation of ovarian cancer, which can serve as a potential therapeutic target. Finally, experiments validated that CSE1L promotes progression, migration, and proliferation of ovarian cancer.ConclusionsOur study has uncovered a robust correlation between variations in cancer intrinsic drivers and stemness, as well as resistance to immunotherapy. This finding provides valuable insights for potential strategies to overcome immune resistance by targeting genes associated with stemness.

BACKGROUND:Adverse factors during pregnancy can significantly increase the incidence of hypertension in adult offspring. Activation of the sympathetic nervous system is closely associated with the development and progression of hypertension. METHODS:We established a model of offspring hypertension induced by prenatal fine particulate matter exposure to evaluate the role of the sympathetic nervous system activation. Quantitative immunofluorescence and Western blot analysis were used to assess the levels of activated and inhibitory sympathetic neurons. The effects of the central and peripheral sympathetic nervous systems were evaluated using clonidine and renal sympathetic denervation. In addition, the activation of microglia in the lateral ventricle region and the expression of the Nrf2 (nuclear factor E2-related factor)/ NLRP3 (NLR family pyrin domain-containing 3) signaling pathway were analyzed. RESULTS:The adult offspring showed increased neuronal hyperactivity and sympathetic nervous system activity. Specific inhibition of the central sympathetic nervous system and renal denervation effectively reversed the prenatal fine particulate matter-induced blood pressure elevation in adult offspring. In addition, overactivation of oxidative stress and microglia-mediated inflammation in the paraventricular nucleus was responsible for increased central sympathetic activity in the adult offspring exposed to prenatal fine particulate matter. Furthermore, we confirmed the critical role of the Nrf2/NLRP3 signaling pathway in oxidative stress and inflammation activation in the paraventricular nucleus of adult offspring. CONCLUSIONS:Overall, prenatal fine particulate matter exposure induces excessive inflammation and oxidative stress in paraventricular nucleus microglia through the Nrf2/NLRP3 signaling pathway, resulting in central and peripheral sympathetic overactivation, leading to hypertension and left ventricular hypertrophy.

BackgroundThe correlation between oxidative stress and female infertility pathogenesis was established, and the oxidative balance score (OBS) can serve as a measure of overall oxidative stress burden within an individual. Prior reports have not addressed the relationship between OBS and female infertility. This study endeavors to investigate the association between infertility risk in female and OBS.MethodsThe analysis focused on data from the National Health and Nutrition Examination Survey 2013-2018. OBS was determined from 16 dietary components and 4 lifestyle components. Multivariate logistic regression was employed to investigate the relationship between OBS and female infertility. Further stratified analysis was conducted to examine the associations across various subgroups. To elucidate the dose-response relationship between infertility risk in female and OBS, a restricted cubic spline function was employed.ResultsThe study included a total of 1410 participants. Through weighted multivariable logistic regression analysis, we observed a consistent inverse correlation between OBS and the risk of female infertility [OR (95% CI) = 0.97 (0.95, 0.99), p = 0.047]. When participants were segregated into quartiles based on OBS, those in the highest quartile had a 61% [OR (95% CI) = 0.39 (0.2, 0.79), p = 0.01] reduced risk of infertility compared to those in the lowest quartile of OBS. A trend test assessing OBS by quartile also revealed the relationship between OBS and female infertility. This correlation remained constant across both dietary and lifestyle OBS. Additionally, lifestyle OBS and female infertility exhibited a nonlinear association. A sensitivity analysis verified the consistency of our findings.ConclusionThe study found that a higher OBS is associated with a lower prevalence of female infertility. These results emphasized the potential role of oxidative homeostasis in the pathogenesis of infertility and highlighted the importance of follow-up studies and prevention strategies.

Background Intractable postpartum hemorrhage (PPH) during cesarean section has been a significant concern for obstetricians. We aimed to explore the effectiveness and safety of a new type of uterine compression suture, the step-wise surgical technique of knapsack-like sutures for treating intractable PPH caused by uterine atony and placenta factors in cesarean section. Methods The step-wise surgical technique of knapsack-like sutures was established on the basis of the artful combination of vertical strap-like sutures and an annular suture-ligation technique. This novel surgical technique was applied to 34 patients diagnosed with PPH during cesarean section due to severe uterine atony and placental factors in our department. The hemostatic effects, clinical outcomes and follow-up visit results were all reviewed and analyzed. Results This new uterine compression suture successfully stopped bleeding in 33 patients, and the effective rate was 97.06%. Only 1 patient failed and was changed to use bilateral uterine arterial embolization and internal iliac artery embolization. The follow-up visits indicated that 33 patients restored menstruation except for 1 who was diagnosed with amenorrhea. The gynecological ultrasound tests of all the patients suggested good uterine involutions, and they had no obvious complaints such as hypogastralgia. Conclusions This step-wise surgical technique of knapsack-like uterine compression sutures can compress the uterus completely. It is a technique that can conserve the uterus and fertility function without special equipment in caesarean section for PPH, with the characteristics of being safe, simple and stable (3 S) with rapid surgery, reliable hemostasis and resident doctor to operation (3R).

目的 探讨在宫腔内人工授精(IUI)助孕过程中,体质量指数(BMI)对年轻不孕妇女妊娠结局的影响,并分析其余有效影响因素,以缩短疗程,降低治疗费用,提高临床妊娠率.方法 回顾性分析2016年9月至2022年8月在滨州医学院附属医院生殖中心进行夫精IUI助孕的1 082对年轻夫妇的第1个IUI周期的临床资料,比较分析正常体质量组(A组)、超重组(B组)和肥胖组(C组)患者的年龄、不孕年限、基础卵泡刺激素(FSH);多囊卵巢综合征(PCOS)/对照等基本资料与IUI助孕结局的关系.组间比较采用Kruskal-Wallis H检验、采用x2检验或Fisher确切概率法,多因素logistic回归分析各数据与临床妊娠率及活产率的关系.结果 3组间年龄、不孕年限、基础FSH、自然/促排、PCOS/对照差异均有统计学意义(P＜0.05);各组间临床妊娠率、活产率及流产率等妊娠结局指标差异无统计学意义(P＞0.05);影响IUI临床妊娠率、活产率及流产率的女性相关因素logistic回归分析显示,促排卵治疗对临床妊娠率及活产率的影响差异有统计学意义(OR=1.564、1.619,P＜0.05);不孕年限对活产率的影响也具有统计学意义(OR=0.884,P＜0.05).结论 在年轻不孕女性的IUI助孕过程中,BMI不会影响妊娠结局,但是促排卵治疗有助于获得临床妊娠及活产率,同时不孕年限也会影响到活产率.

Endometriosis (EMT) is a prevalent gynecological disorder characterized by pain and infertility associated with the menstrual cycle. Pyroptosis, an emerging cell death mechanism, has been implicated in the pathogenesis of diverse diseases, highlighting its pivotal role in disease progression. Therefore, our study aimed to investigate the impact of pyroptosis in EMT using a comprehensive bioinformatics approach. We initially obtained two datasets from the Gene Expression Omnibus database and performed differential expression analysis to identify pyroptosis-related genes (PRGs) that were differentially expressed between EMT and non-EMT samples. Subsequently, several machine learning algorithms, namely least absolute shrinkage selection operator regression, support vector machine-recursive feature elimination, and random forest algorithms were used to identify a hub gene to construct an effective diagnostic model for EMT. Receiver operating characteristic curve analysis, nomogram, calibration curve, and decision curve analysis were applied to validate the performance of the model. Based on the selected hub gene, differential expression analysis between high- and low-expression groups was conducted to explore the functions and signaling pathways related to it. Additionally, the correlation between the hub gene and immune cells was investigated to gain insights into the immune microenvironment of EMT. Finally, a pyroptosis-related competing endogenous RNA network was constructed to elucidate the regulatory interactions of the hub gene. Our study revealed the potential contribution of a specific PRG to the pathogenesis of EMT, providing a novel perspective for clinical diagnosis and treatment of EMT.

目的 分析影响多囊卵巢综合征(PCOS)患者冻融周期活产率的因素并构建诺莫预测模型.方法 纳入取卵后冻融周期移植的 129 例PCOS患者为训练集,通过单因素及多因素分析筛选活产率的影响因素,运用R软件构建诺莫模型,然后经过非同期61 例患者构成的验证集外部验证.结果 训练集和验证集的活产率分别为 57.56%和42.62%,有无优质胚胎(P=0.002)、移植胚胎数目(P=0.021)、身体质量指数(BMI)(P=0.024)及是否血脂异常(P=0.029)是预测活产率的独立影响因素,由此构建的诺莫模型ROC曲线下面积(AUC)在训练集和验证集分别为0.765(95%CI为0.632～0.859)和0.713(95%CI为0.639～0.782),校准曲线反映模型亦较好的校准能力.结论 有无优质胚胎、移植胚胎数目、BMI及是否血脂异常是影响PCOS患者首次冻融周期妊娠结局的影响因素,该模型可以可视化、量化地体现患者的预后,为临床决策及医患沟通提供直观的信息.

多囊卵巢综合征(PCOS)是影响女性健康最常见的生殖内分泌疾病之一,也是辅助生殖助孕的一项重要指征.大量研究证实PCOS患者发生胰岛素抵抗(IR)、2型糖尿病、非酒精性脂肪肝和心血管疾病的风险显著升高,因此PCOS已成为影响患者终身健康的代谢性疾病.尽管IR并非PCOS的诊断标准,但PCOS患者中IR普遍存在且病理生理特征明显.雄激素在IR发生过程中具有双向调节效应,两者之间存在复杂的相互作用.骨骼肌是雄激素作用的靶器官,在维持代谢稳态中发挥关键作用,也是胰岛素介导葡萄糖利用的主要场所.近年来,骨骼肌代谢功能障碍在PCOS发病中的作用逐渐成为学界关注的焦点.分析PCOS女性骨骼肌代谢功能障碍的特征及可能的分子机制,或将为改善PCOS患者的代谢功能提供新的治疗思路.

Controlled ovarian hyperstimulation (COH) is an essential for in vitro fertilization-embryo transfer (IVF-ET) and an important aspect of assisted reproductive technology (ART). Individual starting doses of gonadotropin (Gn) is a critical decision in the process of COH. It has a crucial impact on the number of retrieved oocytes, the cancelling rate of ART cycles, and complications such as ovarian hyperstimulation syndrome (OHSS), as well as pregnancy outcomes. How to make clinical team more standardized and accurate in determining the starting dose of Gn is an important issue in reproductive medicine. In the past 20 years, research teams worldwide have explored prediction models for Gn starting doses. With the integration of artificial intelligence (AI) and deep learning, it is hoped that there will be more suitable predictive model for Gn starting dose in the future.

BACKGROUND:H19 is the first long noncoding RNA (lncRNA) found to be associated with gene imprinting. It is highly expressed in the embryonic stage and may have important regulatory effects on human embryonic development. We investigated the differences between the levels of H19 promoter DNA methylation in the chorionic villi of patients who experienced spontaneous abortion (SA) following in vitro fertilization embryo transfer (IVF-ET) and those of patients with a normal early pregnancy (NEP). We also analyzed the associated DNA methyltransferase (DNMT) activity. METHODS:Chorionic villus tissue from patients with SA and NEP were collected. The DNA methylation levels of two CpG islands in the promoter region of the H19 gene in the two groups were detected by bisulfite sequencing, and the mRNA expression of DNMTs was analyzed by real-time polymerase chain reaction. RESULTS:The sample size of each group was 32, and there were no significant differences in baseline data, including age, parity, and body mass index, between the two groups. Among the 7 CpG islands measured, the methylation rates of 3 CpG islands (CpG 1, 6, and 7) were significantly lower in the SA group than in the NEP group (P < 0.01). The methylation levels of the other 4 CpG islands were not significantly different between the two groups. There were no differences in the expression of DNMT1 between the two groups (P > 0.05), but DNMT3a and DNMT3b RNA levels were significantly lower in SA group than in the NEP group (P < 0.01). CONCLUSIONS:The lower H19 promoter DNA methylation levels found in the chorionic villi of patients with SA patients following IVF-ET may be explained by decreased expression of DNMT3a and DNMT3b.

目的 探讨时差成像系统对复苏周期单囊胚移植妊娠结局的影响.方法 选取在本中心接受体外受精(IVF)或卵胞浆内单精子注射(ICSI)治疗的 113 个周期,将每周期获得的受精卵随机分配到时差成像系统(实验A组)和桌面培养箱(对照B组)进行卵裂期胚胎培养,囊胚培养全部转入桌面培养箱进行,同一培养系统胚胎同一液滴集合培养,按照受精方式和年龄进行分层,比较两组2PN卵裂率、D3 优质胚胎率、囊胚形成率、可利用囊胚形成率、优质囊胚形成率.将集合培养形成的可用囊胚进行冻存,并对第一次复苏周期囊胚移植的妊娠结局进行分析.复苏囊胚来源于时差成像系统的为实验C组(42 周期),来源于桌面培养箱的为对照D组(33 周期).结果 实验A组和对照B组患者的2PN卵裂率、D3 优质胚胎率、囊胚形成率、可利用囊胚形成率、优质囊胚形成率比较,差异无统计学意义.实验C组和对照D组患者的年龄、转化日内膜厚度、流产率比较,差异无统计学意义;但实验C组的临床妊娠率(83.33%vs 60.61%)和着床率(83.33%vs 60.61%)显著高于对照D组(P＜0.05).结论 时差成像系统对胚胎发育没有明显不利影响,可能改善复苏周期囊胚移植的临床妊娠结局.

Adenomyosis is a diffuse or localized organic disease caused by benign invasion of endometrial glands and stroma into the myometrium. It is a common disease that seriously affects reproductive health of women in childbearing age. Due to the unknown etiology and pathophysiological mechanism, and the lack of unified diagnostic criteria and effective treatment methods, total or subtotal hysterectomy has become a radical treatment for adenomyosis, which will lead to the complete loss of fertility. With the continuous exploration of the treatment to adenomyotic patients who have infertility or fertility intentions, new drugs, surgical methods and treating concepts appears. Adopt individualized conservative therapeutic strategies for patients with different conditions, preserve the uterus as much as possible and protect the patient’s fertility, which will play an important role on the follow-up assisted reproductive treatment and long-term management of adenomyosis.

目的 探讨术前行宫腔镜检查进行宫腔预处理对夫精人工授精(IUI)妊娠结局的影响.方法回顾性分析2017年1月至2021年10月首次于滨州医学院附属医院生殖医学科行IUI助孕的1 062个治疗周期的临床资料.选取其中女方双侧输卵管均通畅的964个周期纳入研究,按术前是否行宫腔镜检查分为观察组和对照组.观察组包括IUI术前行宫腔镜检查进行宫腔预处理的616个周期;对照组包括IUI术前未行宫腔镜检查的348个周期.分析两组患者的临床特征和助孕结局.结果 两组在年龄、不孕年限、基础促卵泡激素(bFSH)、基础黄体生成素(bLH)、抗穆勒氏管激素(AMH)、体重指数(BMI)、处理后前向运动精子总数、手术日内膜厚度、不孕类型占比、促排卵周期占比等方面的临床特征比较,差异均无统计学意义(P＞0.05).观察组临床妊娠率、异位妊娠率、活产率均高于对照组,差异均无统计学意义(P＞0.05).观察组流产率明显低于对照组,差异有统计学意义(P＜0.05).结论 双侧输卵管通畅的不孕症患者,IUI术前行宫腔镜检查进行宫腔预处理能够显著降低流产率,对提高活产率有积极的作用.