Erin Foran Wolff1, Nima Vahidi, Connie Alford, Kevin Richter, Eric Widra. 1. Unit on Reproductive Regenerative Medicine, Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA. wolffe@mail.nih.gov
Abstract
OBJECTIVE: To characterize relationships associated with adverse endometrial development in patients undergoing IUI for unexplained infertility. DESIGN: A retrospective review of 2,929 patients from 2004-2011. SETTING: Large metropolitan infertility practice. PATIENT(S): Patients with unexplained infertility undergoing first IUI cycle at age less than 43 years, with a total motile sperm count ≥ 8 million. INTERVENTION(S): Clomiphene citrate (CC) with FSH stimulation followed by IUI. MAIN OUTCOME MEASURE(S): Endometrial thickness, serum E2 (in picograms per milliliter) levels on the day of hCG trigger administration, body mass index (BMI) (in kilograms per meter squared), total motile sperm, follicle number, and clinical pregnancy. RESULT(S): Of the 2,929 patients who met the inclusion criteria, 466 (15.9 %) achieved a clinical pregnancy. Pregnancy rates (PRs) increased significantly with increasing endometrial thickness on the day of hCG administration and with increasing serum E2 level, but were not significantly related to age, BMI, or follicle numbers according to multiple logistic regression modeling. Peak endometrial thickness declined with age and increasing E2 levels. The BMI was associated with thicker endometrium, but it was also associated with lower peak E2 levels. CONCLUSION(S): The impact of "endometrial factor" infertility may be underappreciated in IUI therapy. Targeted therapies to optimize the endometrium represent an important new area to improve in current fertility success rates. Published by Elsevier Inc.
OBJECTIVE: To characterize relationships associated with adverse endometrial development in patients undergoing IUI for unexplained infertility. DESIGN: A retrospective review of 2,929 patients from 2004-2011. SETTING: Large metropolitan infertility practice. PATIENT(S): Patients with unexplained infertility undergoing first IUI cycle at age less than 43 years, with a total motile sperm count ≥ 8 million. INTERVENTION(S): Clomiphene citrate (CC) with FSH stimulation followed by IUI. MAIN OUTCOME MEASURE(S): Endometrial thickness, serum E2 (in picograms per milliliter) levels on the day of hCG trigger administration, body mass index (BMI) (in kilograms per meter squared), total motile sperm, follicle number, and clinical pregnancy. RESULT(S): Of the 2,929 patients who met the inclusion criteria, 466 (15.9 %) achieved a clinical pregnancy. Pregnancy rates (PRs) increased significantly with increasing endometrial thickness on the day of hCG administration and with increasing serum E2 level, but were not significantly related to age, BMI, or follicle numbers according to multiple logistic regression modeling. Peak endometrial thickness declined with age and increasing E2 levels. The BMI was associated with thicker endometrium, but it was also associated with lower peak E2 levels. CONCLUSION(S): The impact of "endometrial factor" infertility may be underappreciated in IUI therapy. Targeted therapies to optimize the endometrium represent an important new area to improve in current fertility success rates. Published by Elsevier Inc.
Authors: Randi H Goldman; Maria Batsis; Michele R Hacker; Irene Souter; John C Petrozza Journal: Am J Obstet Gynecol Date: 2014-05-29 Impact factor: 8.661
Authors: Marília Porto Bonow; Ricardo Ditzel Delle Donne; Vinicius Bonato da Rosa; José Augusto Lucca; Cristian Maio Hillesheim; Alessandro Schuffner Journal: JBRA Assist Reprod Date: 2019-10-14