Efficacy of intrauterine insemination in women with endometrioma-associated subfertility: analysis using propensity score matching

Abstract Background Intrauterine insemination (IUI) treatment is recommended in subfertile women with AFS/ASRM stage I/II endometriosis. However, the efficacy of IUI in women with ovarian endometriomas with tubal patency is uncertain. We explored the efficacy of IUI for the treatment of endometrioma-associated subfertility. Methods We performed a retrospective matched cohort study using propensity matching (PSM) analysis. Subfertile couples undergoing IUI with and without ovarian stimulation between January 1, 2015, and May 30, 2020 were reviewed. Results After PSM, 56 women with endometrioma alone were matched to 173 patients with unexplained subfertility. The per-cycle pregnancy rate (PR) was comparable between women with endometrioma-associated subfertility (n = 56, 87 cycles) and women with unexplained subfertility (n = 173, 280 cycles) (9.2% vs. 17.9%, OR 0.47; 95% CI, 0.21–1.03). Subgroup analyses based on IUI with or without stimulation also resulted in comparable results. A trend toward a lower cumulative pregnancy rates (CPRs) was seen in women with endometrioma (14.3%, 8/56) compared with women with unexplained subfertility (28.9%, 50/173), but the differences were not significant (HR 0.49; 95% CI, 0.23–1.15). However, patients with endometrioma were nearly twice as likely to converse to IVF treatment compared with those without the disease (60.7% versus 43.9%; OR 1.97; 95% CI, 1.07–3.65). Conclusion IUI may be a viable approach for subfertile women with endometrioma and no other identifiable infertility factor. More studies are needed to reassure the findings.

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Efficacy of Intrauterine Insemination in Women with Endometrioma-Associated Subfertility: Analysis Using Propensity Score Matching

10.21203/rs.3.rs-930037/v1 ◽

2021 ◽

Author(s):

Jinlin Xie ◽

He Cai ◽

Juanzi Shi ◽

Hui Wang

Keyword(s):

Cohort Study ◽

Propensity Score ◽

Ovarian Stimulation ◽

Intrauterine Insemination ◽

Matched Cohort ◽

Tubal Patency ◽

Propensity Matching ◽

Subgroup Analyses ◽

Viable Approach ◽

Ovarian Endometriomas

Abstract Background: Intrauterine insemination (IUI) treatment is recommended in subfertile women with AFS/ASRM stage I/II endometriosis. However, the efficacy of IUI in women with ovarian endometriomas with tubal patency is uncertain. We explored the efficacy of IUI for the treatment of endometrioma-associated subfertility.Methods: We performed a retrospective matched cohort study using propensity matching (PSM) analysis. Subfertile couples undergoing IUI with and without ovarian stimulation between January 1, 2015, and May 30, 2020 were reviewed.Results: After PSM, 56 women with endometrioma alone were matched to 173 patients with unexplained subfertility. The per-cycle pregnancy rate (PR) was comparable between women with endometrioma-associated subfertility (n=56, 87 cycles) and women with unexplained subfertility (n=173, 280 cycles) (9.2% vs. 17.9%, OR 0.47; 95% CI, 0.21–1.03). Subgroup analyses based on IUI with or without stimulation also resulted in comparable results. A trend toward a lower cumulative pregnancy rates (CPRs) was seen in women with endometrioma (14.3%, 8/56) compared with women with unexplained subfertility (28.9%, 50/173), but the differences were not significant (OR, 0.54; 95% CI, 0.26-1.15). However, patients with endometrioma were nearly twice as likely to converse to IVF treatment compared with those without the disease (60.7% versus 43.9%; OR, 1.97; 95% CI, 1.07-3.65).Conclusion: IUI may be a viable approach for subfertile women with endometrioma and no other identifiable infertility factor. More studies are needed to reassure the findings.

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Sodium–Glucose Cotransporter 2 Inhibitors and Risk of Retinal Vein Occlusion Among Patients With Type 2 Diabetes: A Propensity Score–Matched Cohort Study

10.2337/figshare.14824089 ◽

2021 ◽

Author(s):

Min-Kyung Lee ◽

Bongsung Kim ◽

Kyungdo Han ◽

Jae-Hyuk Lee ◽

Minhee Kim ◽

...

Keyword(s):

Cohort Study ◽

Propensity Score ◽

Retinal Vein Occlusion ◽

Sglt2 Inhibitors ◽

Matched Cohort ◽

Matched Cohort Study ◽

Vein Occlusion ◽

Sodium Glucose Cotransporter ◽

Increased Risk ◽

Subgroup Analyses

OBJECTIVE To assess the association between use of sodium-glucose cotransporter-2 (SGLT2) inhibitors and retinal vein occlusion (RVO) using data from the National Health Insurance Service in South Korea. RESEARCH DESIGN AND METHODS We used an active comparator, new user design and nationwide data from 2014 to 2017. Based on a 1:1 propensity score match, we included 47 369 new users of SGLT2 inhibitors and 47 369 users of other glucose-lowering drugs (oGLD). In the matched sample, we used the Cox proportional hazards model to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for developing RVO. Based on the main outcome, exploratory subgroup analyses were undertaken. RESULTS During the follow-up of 2.57 years, the incidence rate of RVO was 2.19 and 1.79 per 1000 person-years in patients treated with SGLT2 inhibitors and oGLD, respectively. The new use of SGLT2 inhibitors was associated with an increased risk of RVO compared with oGLD use (HR 1.264, 95% CI 1.056–1.513). In the subgroup analyses, a significant interaction with SGLT2 inhibitors was observed for age and estimated glomerular filtration rate (eGFR); the HR for RVO was higher in patients aged ≥ 60 years and those with eGFR <60 mL/min/1.73m2 than in others. CONCLUSIONS In a matched cohort study, we found that SGLT2 inhibitors were associated with a significantly increased risk of RVO. The older patients and those with chronic kidney disease were at higher risk for RVO.

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