Literature DB >> 32215826

Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success.

Valentina Immediata1, Pasquale Patrizio2, Maria Rosaria Parisen Toldin1, Emanuela Morenghi3, Camilla Ronchetti1, Federico Cirillo1, Annamaria Baggiani1, Elena Albani1, Paolo Emanuele Levi-Setti4,5.   

Abstract

PURPOSE: To report our experience on homologous intrauterine insemination (IUI) with gonadotropin controlled ovarian stimulation (COS) cycles and to examine different variables which could predict IUI success.
MATERIALS AND METHODS: This is a retrospective analysis of IUIs performed between January 1997 and December 2017. A total of 7359 COS IUI's procedures (2901 couples) were reviewed. Clinical pregnancy, live birth rate and age, body mass index (BMI), smoking habit, duration of infertility, sperm characteristics before and after treatment (total motile count, morphology, and vitality), day 3 FSH, total gonadotropin dose, and number of follicles were assessed by multivariate logistic regression analysis, and data were expressed as odds ratio (OR).
RESULTS: The mean female age at the time of COS was 35.10 ± 3.93 years. The most common single infertility diagnoses were unexplained infertility (53.55%), mild male factor (19.69%), and anovulation (10.95%). The total progressive motile sperm count (TPMC) was > 1 × 106/ml (mean 1.34 ± 1.08 × 106/ml). The clinical pregnancy rate was 9.38%, and the live birth rate was 7.19% per cycle. Twin pregnancies were 12.17%. Cumulative pregnancy was 21.89% and cumulative live birth rate was 17.58% per couple. Clinical pregnancy and live birth rates were significantly associated with female age [OR 0.97 (95% CI 0.95-0.99) and 0.95 (95% CI 0.93-0.97), respectively] and day 3 FSH [OR 0.91 (95% CI 0.87-0.94) e 0.90 (95% CI 0.87-0.94), respectively].
CONCLUSIONS: Clinical pregnancy rate and live birth rates after COS-IUIs were significantly influenced by female age and FSH levels. TRIAL REGISTRATION: Clinical trial registration number: NCT03836118.

Entities:  

Keywords:  Infertility; Intrauterine Insemination; Maternal Age; Ovarian Reserve

Mesh:

Substances:

Year:  2020        PMID: 32215826      PMCID: PMC7244676          DOI: 10.1007/s10815-020-01752-3

Source DB:  PubMed          Journal:  J Assist Reprod Genet        ISSN: 1058-0468            Impact factor:   3.412


  30 in total

1.  Intrauterine insemination with ovarian stimulation versus expectant management for unexplained infertility (TUI): a pragmatic, open-label, randomised, controlled, two-centre trial.

Authors:  Cynthia M Farquhar; Emily Liu; Sarah Armstrong; Nicola Arroll; Sarah Lensen; Julie Brown
Journal:  Lancet       Date:  2017-11-23       Impact factor: 79.321

2.  Assessment and treatment for people with fertility problems: NICE guideline.

Authors:  Norma O'Flynn
Journal:  Br J Gen Pract       Date:  2014-01       Impact factor: 5.386

3.  Stimulated intrauterine insemination for unexplained subfertility.

Authors:  Anupa Nandi; Tarek El-Toukhy
Journal:  Lancet       Date:  2017-11-23       Impact factor: 79.321

4.  Clomifene citrate and intrauterine insemination as first-line treatments for unexplained infertility: are they cost-effective?

Authors:  S Wordsworth; J Buchanan; J Mollison; K Harrild; L Robertson; C Tay; A Harrold; D McQueen; H Lyall; L Johnston; J Burrage; S Grossett; H Walton; J Lynch; A Johnstone; S Kini; A Raja; A Templeton; S Bhattacharya
Journal:  Hum Reprod       Date:  2010-12-02       Impact factor: 6.918

5.  A randomized clinical trial to evaluate optimal treatment for unexplained infertility: the fast track and standard treatment (FASTT) trial.

Authors:  Richard H Reindollar; Meredith M Regan; Peter J Neumann; Bat-Sheva Levine; Kim L Thornton; Michael M Alper; Marlene B Goldman
Journal:  Fertil Steril       Date:  2009-06-16       Impact factor: 7.329

6.  Is IVF-served two different ways-more cost-effective than IUI with controlled ovarian hyperstimulation?

Authors:  R I Tjon-Kon-Fat; A J Bensdorp; P M M Bossuyt; C Koks; G J E Oosterhuis; A Hoek; P Hompes; F J Broekmans; H R Verhoeve; J P de Bruin; R van Golde; S Repping; B J Cohlen; M D A Lambers; P F van Bommel; E Slappendel; D Perquin; J Smeenk; M J Pelinck; J Gianotten; D A Hoozemans; J W M Maas; H Groen; M J C Eijkemans; F van der Veen; B W J Mol; M van Wely
Journal:  Hum Reprod       Date:  2015-08-12       Impact factor: 6.918

Review 7.  IUI: review and systematic assessment of the evidence that supports global recommendations.

Authors:  Ben Cohlen; Aartjan Bijkerk; Sheryl Van der Poel; Willem Ombelet
Journal:  Hum Reprod Update       Date:  2018-05-01       Impact factor: 15.610

8.  Prevention of multiple pregnancies in couples with unexplained or mild male subfertility: randomised controlled trial of in vitro fertilisation with single embryo transfer or in vitro fertilisation in modified natural cycle compared with intrauterine insemination with controlled ovarian hyperstimulation.

Authors:  A J Bensdorp; R I Tjon-Kon-Fat; P M M Bossuyt; C A M Koks; G J E Oosterhuis; A Hoek; P G A Hompes; F J M Broekmans; H R Verhoeve; J P de Bruin; R van Golde; S Repping; B J Cohlen; M D A Lambers; P F van Bommel; E Slappendel; D Perquin; J M Smeenk; M J Pelinck; J Gianotten; D A Hoozemans; J W M Maas; M J C Eijkemans; F van der Veen; B W J Mol; M van Wely
Journal:  BMJ       Date:  2015-01-09

9.  Clomifene citrate or unstimulated intrauterine insemination compared with expectant management for unexplained infertility: pragmatic randomised controlled trial.

Authors:  S Bhattacharya; K Harrild; J Mollison; S Wordsworth; C Tay; A Harrold; D McQueen; H Lyall; L Johnston; J Burrage; S Grossett; H Walton; J Lynch; A Johnstone; S Kini; A Raja; A Templeton
Journal:  BMJ       Date:  2008-08-07

10.  The revival of intrauterine insemination: evidence-based data have changed the picture.

Authors:  Willem Ombelet
Journal:  Facts Views Vis Obgyn       Date:  2017-09
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  2 in total

1.  The Use of Pooled Consecutive Ejaculates in Moderate Male Factor Infertility to Increase Intrauterine Insemination Success.

Authors:  Sumana Gurunath; Swathi Gundlapalli; John Louis
Journal:  J Hum Reprod Sci       Date:  2021-06-28

2.  Clomiphene Citrate versus Recombinant FSH in intrauterine insemination cycles with mono- or bi-follicular development.

Authors:  Vehbi Yavuz Tokgoz; Yavuz Emre Sukur; Batuhan Ozmen; Murat Sonmezer; Bulent Berker; Rusen Aytac; Cem Somer Atabekoglu
Journal:  JBRA Assist Reprod       Date:  2021-07-21
  2 in total

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