Mohammad A Maher1,2, Ahmed Abdelaziz3,4, Yasser A Shehata5. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Shebin-Elkom, Egypt. 2. Al-Hayat National Hospital, Khamis-Mushait, Saudi Arabia. 3. Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-shams University, Cairo, Egypt. 4. Armed Forces Hospital North-West Region, Tabouk, Saudi Arabia. 5. Department of Public Health and Community Medicine, Menoufia University, Shebin-Elkom, Egypt.
Abstract
OBJECTIVE: To compare pregnancy outcomes when triggering ovulation at different follicle sizes during intrauterine insemination (IUI) cycles. METHODS: A prospective observational study was undertaken at two collaborative fertility centers in Saudi Arabia between January 2014 and May 2016. Women of any age were enrolled if they met inclusion criteria: primary, secondary, or unexplained infertility (≥1 year); day-2 follicle-stimulating hormone less than 12 IU/mL; normal prolactin, thyroid function, and uterine cavity; at least one patent tube; and a male partner with normal semen count and motility. IUI cycles were subdivided by size of dominant follicle (17 to <18 mm, 18 to <19 mm, 19 to <20 mm, and ≥20 mm), and pregnancy outcomes compared. RESULTS: Data from 516 IUI cycles were analyzed. Frequencies of clinical pregnancy, ongoing pregnancy, and live birth for a follicle size of 19-20 mm were 30.2% (39/129), 24.0% (31/129), and 24.0% (31/129), respectively; these rates were significantly higher than those in other groups (all P<0.05). Only endometrial thickness was found to also contribute to outcome: probability of pregnancy increased as thickness rose (odds ratio 1.148, 95% confidence interval 1.065-1.237; P<0.001). CONCLUSION: The optimal follicular diameter associated with increased pregnancy rates in gonadotropin-stimulated IUI cycles was between 19 and 20 mm.
OBJECTIVE: To compare pregnancy outcomes when triggering ovulation at different follicle sizes during intrauterine insemination (IUI) cycles. METHODS: A prospective observational study was undertaken at two collaborative fertility centers in Saudi Arabia between January 2014 and May 2016. Women of any age were enrolled if they met inclusion criteria: primary, secondary, or unexplained infertility (≥1 year); day-2 follicle-stimulating hormone less than 12 IU/mL; normal prolactin, thyroid function, and uterine cavity; at least one patent tube; and a male partner with normal semen count and motility. IUI cycles were subdivided by size of dominant follicle (17 to <18 mm, 18 to <19 mm, 19 to <20 mm, and ≥20 mm), and pregnancy outcomes compared. RESULTS: Data from 516 IUI cycles were analyzed. Frequencies of clinical pregnancy, ongoing pregnancy, and live birth for a follicle size of 19-20 mm were 30.2% (39/129), 24.0% (31/129), and 24.0% (31/129), respectively; these rates were significantly higher than those in other groups (all P<0.05). Only endometrial thickness was found to also contribute to outcome: probability of pregnancy increased as thickness rose (odds ratio 1.148, 95% confidence interval 1.065-1.237; P<0.001). CONCLUSION: The optimal follicular diameter associated with increased pregnancy rates in gonadotropin-stimulated IUI cycles was between 19 and 20 mm.