Laka Dinelli1, Blandine Courbière2, Vincent Achard3, Elisabeth Jouve4, Carole Deveze1, Audrey Gnisci1, Jean-Marie Grillo3, Odile Paulmyer-Lacroix5. 1. Department of Gynecology-Obstetric and Reproduction, Gynepôle, AP-HM La Conception, Marseille, France. 2. Department of Gynecology-Obstetric and Reproduction, Gynepôle, AP-HM La Conception, Marseille, France; IMBE, Biogénotoxicologie, Santé Humaine & Environnement UMR 6116, Aix-Marseille Université, Marseille FR CNRS 3098, ECCOREV, Aix-en-Provence, France. 3. Department of Gynecology-Obstetric and Reproduction, Gynepôle, AP-HM La Conception, Marseille, France; Department of Histology-Embryology, Faculty of Medicine, Aix-Marseille University, Marseille, France. 4. CIC-CPCET, Data Management and Biostatistics, AP-HM, Marseille, France. 5. Department of Gynecology-Obstetric and Reproduction, Gynepôle, AP-HM La Conception, Marseille, France; Department of Histology-Embryology, Faculty of Medicine, Aix-Marseille University, Marseille, France. Electronic address: odile.lacroix-paulmyer@ap-hm.fr.
Abstract
OBJECTIVE: To identify the prognostic factors for pregnancy after intrauterine insemination with the husband's sperm (IUI-H). DESIGN: Retrospective study. SETTING: A single university medical center. PATIENT(S): 851 couples, for 2,019 IUI-H cycles. INTERVENTION(S): After controlled ovarian stimulation, IUI-H performed 36 hours after ovulation triggering or 24 hours after a spontaneous luteinizing hormone (LH) surge. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate per cycle (PR) and delivery rate per cycle (DR). RESULT(S): The overall PR was 14.8% and DR 10.8%. Higher PR and DR were observed for patients presenting with ovulation disorders (particularly polycystic ovary syndrome) or with male infertility. Secondary infertility in the woman appeared to be a positive prognostic factor as did a basal follicle-stimulating hormone (FSH) level ≤ 7 IU/L and ovulation triggering over spontaneous LH rise. The other parameters influencing the results were the women's age, the number of mature follicles obtained (≥ 2), the endometrial thickness (10-11 mm), and the number of progressive motile spermatozoa inseminated (>1 million). CONCLUSION(S): In women aged ≤ 38 years, IUI-H should be considered as an option, particularly in cases of female infertility from ovulation disorders, in cases of a normal ovarian reserve, in cases of secondary infertility, or when ≥ 1 million progressive sperm are inseminated. Bifollicular stimulation is required. In other cases, in vitro fertilization should be discussed as the first-line treatment.
OBJECTIVE: To identify the prognostic factors for pregnancy after intrauterine insemination with the husband's sperm (IUI-H). DESIGN: Retrospective study. SETTING: A single university medical center. PATIENT(S): 851 couples, for 2,019 IUI-H cycles. INTERVENTION(S): After controlled ovarian stimulation, IUI-H performed 36 hours after ovulation triggering or 24 hours after a spontaneous luteinizing hormone (LH) surge. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate per cycle (PR) and delivery rate per cycle (DR). RESULT(S): The overall PR was 14.8% and DR 10.8%. Higher PR and DR were observed for patients presenting with ovulation disorders (particularly polycystic ovary syndrome) or with male infertility. Secondary infertility in the woman appeared to be a positive prognostic factor as did a basal follicle-stimulating hormone (FSH) level ≤ 7 IU/L and ovulation triggering over spontaneous LH rise. The other parameters influencing the results were the women's age, the number of mature follicles obtained (≥ 2), the endometrial thickness (10-11 mm), and the number of progressive motile spermatozoa inseminated (>1 million). CONCLUSION(S): In women aged ≤ 38 years, IUI-H should be considered as an option, particularly in cases of female infertility from ovulation disorders, in cases of a normal ovarian reserve, in cases of secondary infertility, or when ≥ 1 million progressive sperm are inseminated. Bifollicular stimulation is required. In other cases, in vitro fertilization should be discussed as the first-line treatment.
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Authors: U Punjabi; H Van Mulders; L Van de Velde; I Goovaerts; K Peeters; W Cassauwers; T Lyubetska; K Clasen; P Janssens; O Zemtsova; E Roelant; D De Neubourg Journal: J Assist Reprod Genet Date: 2021-01-05 Impact factor: 3.412
Authors: Karl R Hansen; Jennifer D Peck; R Matthew Coward; Robert A Wild; J C Trussell; Stephen A Krawetz; Michael P Diamond; Richard S Legro; Christos Coutifaris; Ruben Alvero; Randal D Robinson; Peter Casson; Gregory M Christman; Nanette Santoro; Heping Zhang Journal: Hum Reprod Date: 2020-06-01 Impact factor: 6.353