Choriogonadotropin alpha administration is associated with an increased clinical pregnancy rate among infertile couples undergoing controlled ovarian hyperstimulation with intrauterine insemination

Background: Being a diagnosis of exclusion the treatment options of unexplained infertility are often empiric. There is significant dilemma regarding the superiority of one over another. Despite increasing use of intrauterine insemination (IUI) in adjunct to controlled ovarian hyperstimulation (COH) there is scarcity of randomized controlled trials (RCT) from developing countries. Objective was to compare IUI and timed intercourse (TI) in super ovulated cycles among couples with unexplained infertility over one year.Methods: In this prospective randomized controlled trial total 85 patients were randomly assigned into group 1 (COH with IUI, N= 44) and group 2 (COH with TI, N=41). Patients underwent COH using sequential Clomiphene Citrate and injection human menopausal gonadotrophin followed by IUI in group 1 and timed intercourse in group 2. Either protocol was repeated for three consecutive cycles. Finally, both groups were compared for clinical pregnancy rate, adverse effects and acceptability of the treatment process and outcome. Comparison was done by Student’s unpaired t test for continuous and 2-tailed chi square test for categorical variables.Results: Clinical pregnancy rates following COH/IUI and COH/TI were 13.64% and 19.51% respectively. There was observable difference in the acceptability of the outcome (38.64% in IUI and 56.09% in TI group). All the results including complications and side effect rates were statistically insignificant.Conclusions: Present study failed to show any improvement of pregnancy rates following addition of IUI over TI and it raised the probability that the outcome of the procedure may not be well accepted.

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Treatment of ovulatory women with unexplained infertility with clomiphene citrate and intrauterine insemination: does dosage affect clinical pregnancy rate?

Fertility and Sterility ◽

10.1016/j.fertnstert.2011.07.456 ◽

2011 ◽

Vol 96 (3) ◽

pp. S116-S117

Author(s):

N.M. Barker ◽

S. Rahim ◽

M. Johnson ◽

S. Weil ◽

J. Liu ◽

...

Keyword(s):

Pregnancy Rate ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Unexplained Infertility ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate

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Comparative Analysis of Effectiveness of Clomiphene Citrate and Letrozole Combined with Low Dose Human Menopausal Gonadotropin for Controlled Ovarian Stimulation in Intrauterine Insemination Cycles

Siriraj Medical Journal ◽

10.33192/smj.2021.26 ◽

2021 ◽

Vol 73 (3) ◽

pp. 198-203

Author(s):

Padmalaya Thakur ◽

Sujata Pradhan

Keyword(s):

Pregnancy Rate ◽

Ovarian Stimulation ◽

Low Dose ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Controlled Ovarian Stimulation ◽

Human Menopausal Gonadotropin ◽

Group B

Objective: To compare the efficacy of clomiphene citrate and letrozole in combination with low dose human menopausal gonadotropin for controlled ovarian stimulation in intrauterine insemination (IUI) cycles.Methods: During January-2018 to December-2019 for intending 496 IUI cycles, controlled ovarian stimulation was performed with either clomiphene or letrozole combined with human menopausal gonadotropin (hMG), in two arms: subjects in one arm (Group A) were with clomiphene and hMG in 222 cycles; those in the second arm (Group B) were with letrozole and hMG in 274 cycles. Pregnancy rate and clinical pregnancy rate of both groups were considered as the primary outcomes.Results: Patient characteristics like female age, indications for IUI, type of IUI, endometrial thickness and total motile fraction (TMF) of spermatozoa of male partners were seen similar in both groups. The letrozole-hMG group (Group B) had significantly higher numbers of cycles with single dominant follicle (P=0.01) and human chorionic gonadotropin (hCG) was more frequently used as the ovulation trigger (P=0.03). Pregnancy rate (18.5% vs. 15.3%, P=0.35) and clinical pregnancy rate (18.5% vs. 15.3%, P=0.35) were similar in groups A and B, respectively.Conclusion: Clomiphene citrate and letrozole combined with low dose human menopausal gonadotropin were equally effective for controlled ovarian stimulation in IUI cycles.

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

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1404 ◽

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.

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Total Normal Motile Sperm Count Plays no Role in Clinical pregnancy Rate After Intrauterine Insemination

Fertility and Sterility ◽

10.1016/j.fertnstert.2011.01.098 ◽

2011 ◽

Vol 95 (4) ◽

pp. S24 ◽

Cited By ~ 1

Author(s):

Amy Shah ◽

Vicken Sahakian ◽

Catherine DeUgarte

Keyword(s):

Pregnancy Rate ◽

Intrauterine Insemination ◽

Sperm Count ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Motile Sperm

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Pregnancy Rate after Controlled Ovarian Hyperstimulation and Intrauterine Insemination for the Treatment of Endometriosis following Surgery

BioMed Research International ◽

10.1155/2015/282301 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Attila Keresztúri ◽

Zoltan Kozinszky ◽

József Daru ◽

Norbert Pásztor ◽

János Sikovanyecz ◽

...

Keyword(s):

Pregnancy Rate ◽

Outcome Measures ◽

Live Birth ◽

Intrauterine Insemination ◽

Care Center ◽

Tertiary Care ◽

Controlled Ovarian Hyperstimulation ◽

Control Group ◽

Ovarian Hyperstimulation ◽

Significant Difference

Objective. To compare pregnancy rate after controlled ovarian hyperstimulation and intrauterine insemination (COH-IUI) with no treatment in patients with endometriosis-associated infertility treated with laparoscopy.Design. A clinical cohort study.Setting. University-level tertiary care center.Patients. 238 women with various stages of endometriosis after laparoscopic treatment.Interventions. Either COH-IUI or follow-up for 12 months.Main Outcome Measures. The primary outcome measures were clinical pregnancy and live birth rate. Predictive factors evaluated were female age, maternal BMI, and duration of infertility.Results. The pregnancy rate attained after the integrated laparoscopy–COH-IUI approach was 53.4%, while it was significantly lower (38.5%) in the control group. Similarly, a significant difference was observed in live births (48.3% versus 34.2%). Patients with severe endometriosis were less likely to achieve pregnancy (38%) and live birth (35%) than their counterparts with milder forms (57% and 53%).Conclusions. In patients with endometriosis-based infertility, surgery followed by COH-IUI is more effective than surgery alone.

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