Individualized predictions for clinical pregnancy (CPR), multiple pregnancy (MPR), and spontaneous abortion rates (SABR) following ovulation induction / intrauterine insemination (OI/IUI)

2013 ◽  
Vol 100 (3) ◽  
pp. S112
Author(s):  
R.H. Goldman ◽  
M. Batsis ◽  
J.C. Petrozza ◽  
I.C. Souter
Keyword(s):  
Spontaneous Abortion ◽  
Ovulation Induction ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy

scholarly journals The effect of local endometrial injury on the success of intrauterine insemination

2021 ◽  
Vol 38 (4) ◽  
pp. 521-524
Author(s):  
Gazi YILDIZ ◽  
Didar KURT ◽  
Emre MAT ◽  
Pınar YILDIZ
Keyword(s):  
Ovulation Induction ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Study Group ◽  
Randomized Controlled ◽  
Endometrial Injury ◽  
Significant Difference ◽  
Infertile Patients

To determine the effect of local endometrial injury on implantation success in patients diagnosed with unexplained infertility and undergoing intrauterine insemination (IUI) after ovulation induction with gonadotropins. In this prospective randomized controlled trial, 82 infertile patients underwent IUI following ovulation induction with gonadotropin. In the study group (n:40), local endometrial injury (stratch) was performed to the posterior side of the endometrial cavity with a biopsy catheter between the 21-26th days of luteal phase of the cycle preceding ovarian stimulation. There was no statistically significant difference between the study and the control groups in terms of age of female, age of male, duration of infertility, BMI, serum FSH and LH levels, mean dose of gonadotropin and mean duration of ovulation induction (p>0.05). Clinical pregnancy was achieved in two patients (4.76%) in control group and four (10%) patients in the study group, with no significant difference between groups (p=0.18). All pregnancies achieved in the control and the study groups passed 12th gestational weeks and continued. Ectopic pregnancy, multiple pregnancy and abortion was not observed in any patient in both groups. In the study group, pain level immediately after endometrial biopsy procedure was evaluated with visual analog scale (VAS) and it was established that only one (2.5%) patient experienced severe pain after the procedure. Although local endometrial damage in the menstural period before ovulation induction and IUI cycle increases clinical pregnancy rates in the infertile patients, this increase is not statistically significant. Multi-center randomized controlled studies are needed for local endometrial damage to be recommended routinely in clinical practice.

scholarly journals Controlled ovarian stimulation should not be preferred for male infertility treated with intrauterine insemination: a retrospective study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Tang ◽  
Qian-Dong He ◽  
Ting-Ting Zhang ◽  
Jing-Jing Wang ◽  
Si-Chong Huang ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Ovulatory Follicles ◽  
Multiple Pregnancy Rate

Abstract Background Some studies have stated that intrauterine insemination (IUI) with controlled ovarian stimulation (COS) might increase the pregnancy rate, while others suggest that IUI in the natural cycle (NC) should be the first line of treatment. It remains unclear whether it is necessary to use COS at the same time when IUI is applied to treat isolated male factor infertility. Thus, we aimed to investigate efficacy of IUI with COS for isolated male factor infertility. Methods A total of 601 IUI cycles from 307 couples who sought medical care for isolated male factor infertility between January 2010 and February 2020 were divided into two groups: NC-IUI and COS-IUI. The COS-IUI group was further divided into two subgroups according to the number of pre-ovulatory follicles on the day of HCG: cycles with monofollicular development (one follicle group) and cycles with at least two pre-ovulatory follicles (≥ 2 follicles group). The IUI outcomes, including clinical pregnancy, live birth, spontaneous abortion, ectopic pregnancy, and multiple pregnancy rates were compared. Results The clinical pregnancy, live birth, spontaneous abortion, and ectopic pregnancy rates were comparable between the NC-IUI and COS-IUI group. Similar results were also observed among the NC-IUI, one follicle, and ≥ 2 follicles groups. However, with respect to the multiple pregnancy rate, a trend toward higher multiple pregnancy rate was observed in the COS-IUI group compared to the NC-IUI group (8.7% vs. 0, P = 0.091), and a significant difference was found between the NC-IUI and ≥ 2 follicles group (0 vs. 16.7%, P = 0.033). Conclusion In COS cycles, especially in those with at least two pre-ovulatory follicles, the multiple pregnancy rate increased without a substantial gain in overall pregnancy rate; thus, COS should not be preferred in IUI for isolated male factor infertility. If COS is required, one stimulated follicle and one healthy baby should be the goal considering the safety of both mothers and foetuses.

scholarly journals Predictive Factors for Pregnancy after Intrauterine Insemination: A Retrospective Study of Factors Affecting Outcome

2016 ◽  
Vol 8 (2) ◽  
pp. 140-144
Author(s):  
Azadeh Pravin Patel ◽  
Megha Snehal Patel ◽  
Sushma Rakesh Shah ◽  
Shashwat Kamal Jani
Keyword(s):  
Retrospective Study ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Predictive Factors ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Female Age ◽  
Factors Affecting

ABSTRACT Objectives To determine the predictive factors for pregnancy after stimulated intrauterine insemination (IUI). Materials and methods A retrospective analysis of 136 patients undergoing 443 stimulated IUI cycles was done in an attempt to identify significant variables predictive of treatment success. The primary outcome measures were clinical pregnancy and live birth rates. Predictive factors evaluated were female age, duration of infertility, indication for IUI, number of preovulatory follicles, and postwash total motile fraction (TMF). Results The overall clinical pregnancy rate and live birth rate were 7.2% and 5.1 per cycle respectively. The mean number of IUI cycles per patient was 3.2, the miscarriage rate was 15%, and the multiple pregnancy rate was 3.1%. Among the predictive factors evaluated, female age (age > 37 years; p = 0.039), the duration of infertility (5.36 vs 6.71 years, p = 0.032), and the TMF (between 10 and 20 million, p = 0.003) significantly influenced the clinical pregnancy rate. Conclusion The clinical management of the selected infertile couple should be performed in an expedited manner taking into consideration the age of the woman, etiology, and duration of infertility and motile fraction of sperms. How to cite this article Patel AP, Patel MS, Shah SR, Jani SK. Predictive Factors for Pregnancy after Intrauterine Insemination: A Retrospective Study of Factors Affecting Outcome. J South Asian Feder Obst Gynae 2016;8(2):140-144.

scholarly journals Impact of Preconceptional Serum Thyroid Stimulating Hormone Values Ranging Between 2.5 and 4.5 mIU/L on Intrauterine Insemination Outcomes in Euthyroid Women with Unexplained Infertility

2021 ◽  
Author(s):  
Lale Karakis ◽  
Huseyin Kiyak ◽  
Berfin Okmen ◽  
Cagdas Ozdemir ◽  
Engin Turkgeldi
Keyword(s):  
Outcome Measures ◽  
Live Birth ◽  
Ovulation Induction ◽  
Intrauterine Insemination ◽  
Thyroid Stimulating Hormone ◽  
Unexplained Infertility ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Serum Tsh ◽  
Tsh Levels

Abstract Background: Contrary to overt hypothyroidism, the true impact of subclinical hypothyroidism on fertility has not been well established. This study aimed to investigate whether serum thyroid stimulating hormone (TSH) values between 2.5 and 4.5 mIU/L are associated with lower pregnancy rates compared to TSH levels between 0.3-2.5 mIU/L in women undergoing ovulation induction with gonadotropins and intrauterine insemination (IUI) for unexplained infertility.Methods: Medical records of couples with unexplained infertility who underwent IUI treatment between January 2013 and December 2018 were reviewed retrospectively. Cycle characteristics and pregnancy outcomes of patients with serum TSH levels between 0.3-2.49 mIU/L and 2.5–4.5 mIU/L were compared. Primary outcome measures were clinical pregnancy and live birth rate. Secondary outcome measures were total dose of gonadotropin administration, duration of ovulation induction and miscarriage rate.Results: A total of 726 euthyroid women who underwent 1465 cycles of ovulation induction with gonadotropins and IUI were included in the analyses. Patient and cycle characteristics of the two study groups were similar. No statistically significant differences could be detected in the clinical pregnancy (p=0.743) and live birth rates (p=0.380) between the two groups. Duration of ovulation induction, total gonadotropin dosage, number of follicles >17mm on the trigger day and the miscarriage rates were similar in the two groups.Conclusion: In euthyroid women undergoing ovulation induction with gonadotropins and IUI for unexplained infertility, the range of preconceptional serum TSH values between 2.5-4.5 mIU/L is not associated with lower pregnancy rates when compared to TSH levels between 0.3-2.5 mIU/L.

scholarly journals Impact of preconceptional serum thyroid stimulating hormone values ranging between 2.5 and 4.5 mIU/L on live birth rates following ovulation induction and intrauterine insemination treatment for unexplained infertility

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lale Susan Karakis ◽  
Huseyin Kiyak ◽  
Berfin Okmen ◽  
Cagdas Ozdemir ◽  
Engin Turkgeldi
Keyword(s):  
Outcome Measures ◽  
Live Birth ◽  
Ovulation Induction ◽  
Intrauterine Insemination ◽  
Thyroid Stimulating Hormone ◽  
Unexplained Infertility ◽  
Clinical Pregnancy ◽  
Live Birth Rates ◽  
Serum Tsh ◽  
Tsh Levels

Abstract Background Contrary to overt hypothyroidism, the true impact of subclinical hypothyroidism on fertility has not been well established. This study aimed to investigate whether serum thyroid stimulating hormone (TSH) values between 2.5 and 4.5 mIU/L are associated with lower pregnancy rates compared to TSH levels between 0.3 and 2.5 mIU/L in women undergoing ovulation induction with gonadotropins and intrauterine insemination (IUI) for unexplained infertility. Methods Medical records of couples with unexplained infertility who underwent IUI treatment between January 2013 and December 2018 were reviewed retrospectively. Cycle characteristics and pregnancy outcomes of patients with serum TSH levels between 0.3–2.5 mIU/L and 2.5–4.5 mIU/L were compared. Primary outcome measures were clinical pregnancy and live birth rate. Secondary outcome measures were total dose of gonadotropin administration, duration of ovulation induction and miscarriage rate. Results A total of 726 euthyroid women who underwent 1465 cycles of ovulation induction with gonadotropins and IUI were included in the analyses. Patient and cycle characteristics of the two study groups were similar. No statistically significant differences could be detected in the clinical pregnancy (p = 0.74) and live birth rates (p = 0.38) between the two groups. Duration of ovulation induction, total gonadotropin dosage, number of follicles > 17 mm on the trigger day and the miscarriage rates were similar in the two groups. Conclusion In euthyroid women undergoing ovulation induction with gonadotropins and IUI for unexplained infertility, the range of preconceptional serum TSH values between 2.5 and 4.5 mIU/L is not associated with lower pregnancy rates when compared to TSH levels between 0.3 and 2.5 mIU/L.

scholarly journals Controlled ovarian stimulation should not be preferred for male infertility treated with intrauterine insemination: a retrospective study

2021 ◽  
Author(s):  
Yan Tang ◽  
Qian-Dong He ◽  
Ting-Ting Zhang ◽  
Jing-Jing Wang ◽  
Si-Chong Huang ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Ovulatory Follicles ◽  
Multiple Pregnancy Rate

Abstract Background: Some studies have stated that intrauterine insemination (IUI) with controlled ovarian stimulation (COS) might increase the pregnancy rate, while others suggest that IUI in the natural cycle (NC) should be the first line of treatment. It remains unclear whether it is necessary to use COS at the same time when IUI is applied to treat isolated male factor infertility. Thus, we aimed to investigate efficacy of IUI with COS for isolated male factor infertility.Methods: A total of 601 IUI cycles from 307 couples who sought medical care for isolated male factor infertility between January 2010 and February 2020 were divided into two groups: NC-IUI and COS-IUI. The COS-IUI group was further divided into two subgroups according to the number of pre-ovulatory follicles on the day of HCG: cycles with monofollicular development (one follicle group) and cycles with at least two pre-ovulatory follicles (≥ 2 follicles group). The IUI outcomes, including clinical pregnancy, live birth, spontaneous abortion, ectopic pregnancy, and multiple pregnancy rates were compared.Results: The clinical pregnancy, live birth, spontaneous abortion, and ectopic pregnancy rates were comparable between the NC-IUI and COS-IUI group. Similar results were also observed among the NC-IUI, one follicle, and ≥ 2 follicles groups. However, with respect to the multiple pregnancy rate, a trend toward higher multiple pregnancy rate was observed in the COS-IUI group compared to the NC-IUI group (8.7% vs. 0, P=0.091), and a significant difference was found between the NC-IUI and ≥ 2 follicles group (0 vs. 16.7%, P=0.033).Conclusion: In COS cycles, especially in those with at least two pre-ovulatory follicles, the multiple pregnancy rate increased without a substantial gain in overall pregnancy rate; thus, COS should not be preferred in IUI for isolated male factor infertility. If COS is required, one stimulated follicle and one healthy baby should be the goal considering the safety of both mothers and foetuses.

scholarly journals What is the optimal protocol for Intrauterine Insemination (IUI)? A Mini Review and A Retrospective Study to Evaluate Effective Factors Influencing Pregnancy after IUI

2019 ◽  
Author(s):  
Qing Li ◽  
Belén Herrero ◽  
Mao-Ling Zhu ◽  
Josée Lefebvre ◽  
William Buckett
Keyword(s):  
Logistic Regression ◽  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Effective Factors ◽  
Optimal Protocol

Abstract Background: Although it is well documented on the study of intrauterine insemination (IUI), the effectiveness of various factors on IUI treatment is inconsistent. The aim of this study is to investigate the various factors that influence IUI outcome and attempt to set up optimal protocol for IUI patients. Methods: This was a retrospective cohort study including1948 cycles (843 couples) that performed IUI between January 2012 and December 2013 in a single centre. Various factors that may affect IUI outcome were analyzed using chi-square. Moreover, we conducted multiple logistic regression to evaluate the main factors on the effects of IUI outcome. In addition, follicle growth and endometrial development relevant to conception were also assessed among protocols. Results: The clinical pregnancy rate (CPR) per cycle was 12.5% in the present study. Seven factors were identified to be associated significantly with CPR by multivariate logistic regression analysis: female age, type of infertility, ovarian stimulation protocol, preovulatory follicles, endometrial thickness, growing length of preovulatory follicle, post-washed total motile spermatozoa count (TMSC). Comparing with 11 days or less, more than 15 days for ovarian response and endometrial development before insemination induced a better success rate. Although ovarian stimulation with gonadotrophin or letrozole induced higher CPR when comparing to stimulation with clomiphene citrate or without stimulation, ovarian stimulation with letrozole was superior to gonadotrophin by its similar CPR to gonadotrophin but lower follicle number, without the risk of multiple pregnancy. Women younger than 41 years with elevated endometrial thickness inseminated with TMSC ≥ 4.0 million had better chance to obtain pregnancy. Number of treatment cycle was not a factor to affect CPR, with a stable CPR in the first four cycles. Conclusions: We conclude that women no more than 41 years old are suitable to perform at least 4 cycles of IUI before proceeding to IVF. The optimized IUI treatment requires ovarian stimulation with letrozole to induce one/two follicles and fertilize with four or more million motile spermatozoa and an elevated endometrium on day 15 or after in the cycle. Key words: infertility, intrauterine insemination, effective factors, clinical pregnancy rate.

scholarly journals GnRH Agonist versus hCG Trigger in Ovulation Induction with Intrauterine Insemination: A Randomized Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Minh Tam Le ◽  
Dac Nguyen Nguyen ◽  
Jessica Zolton ◽  
Vu Quoc Huy Nguyen ◽  
Quang Vinh Truong ◽  
...  
Keyword(s):  
Ovulation Induction ◽  
Intrauterine Insemination ◽  
Controlled Trial ◽  
Cardiac Activity ◽  
Clinical Pregnancy ◽  
University Hospital ◽  
Ultrasound Monitoring ◽  
Fetal Cardiac Activity ◽  
Gestational Sac ◽  
Hcg Trigger

This study is aimed at comparing clinical pregnancy rates (CPRs) in patients who are administered either gonadotropin-releasing hormone agonist (GnRHa) or human chorionic gonadotropin (hCG) for ovulation trigger in intrauterine insemination (IUI) cycles. A prospective randomized comparative study was conducted at Hue University Hospital in Vietnam. A total of 197 infertile women were randomly assigned to receive either GnRHa trigger (n=98 cycles) or hCG trigger (n=99 cycles) for ovulation trigger. Patients returned for ultrasound monitoring 24 hours after IUI to confirm ovulation. A clinical pregnancy was defined as the presence of gestational sac with fetal cardiac activity. There was no difference in ovulation rates in either group receiving GnRHa or hCG trigger for ovulation. Biochemical and CPR were higher in patients who received hCG (28.3% and 23.2%) versus GnRHa (14.3% and 13.3%) (p=0.023, OR 0.42, 95%CI=0.21−0.86 and p=0.096, OR 0.51, 95%CI=0.24−1.07, respectively). After adjusting for body mass index (BMI) and infertility duration, there was no difference in CPR between the two groups (OR 0.58, 95% CI 0.27-1.25, p=0.163). In conclusion, the use of the GnRHa to trigger ovulation in patients undergoing ovulation induction may be considered in patients treated with IUI.

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