International Journal of
Reproductive Biomedicine
Tue, Apr 23, 2024
[Archive]
Volume 9, Issue 1 (7-2011)
IJRM 2011, 9(1): 0-0 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Ebrahimi M, Akbari Asbagh F, Ghaseminejad A. Controlled ovarian hyperstimulation and intrauterine insemination cycles in patients with unilateral tubal blockage diagnosed by hysterosalpingography. IJRM 2011; 9 (1)
URL: http://ijrm.ir/article-1-205-en.html
URL: http://ijrm.ir/article-1-205-en.html
1- Department of Obstetrics and Gynecology, Mirza Koochak Khan Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran , Iran , Maeb214@Yahoo.com
2- Department of Obstetrics and Gynecology, Mirza Koochak Khan Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran , Iran
2- Department of Obstetrics and Gynecology, Mirza Koochak Khan Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran , Iran
Abstract: (2634 Views)
Background: Controlled ovarian hyperstimulation and intrauterine insemination (IUI) cycle is an ideal protocol for some subfertile patients. So, we decided to try this therapeutic protocol for the patients with unilateral tubal blockage diagnosed by hysterosalpingography (HSG).
Objective: To evaluate the effect of unilateral tubal blockage diagnosed by HSG on cumulative pregnancy rate (CPR) of the stimulated IUI cycles.
Materials and Methods: A cross-sectional analysis was performed between October 2006 and October 2009 in an academic reproductive endocrinology and infertility center. Two groups of patients undergoing stimulated IUI cycles were compared. Sixty-four infertile couples with unilateral tubal blockage diagnosed by HSG as the sole cause of infertility in the group (І), and two hundred couples with unexplained infertility in the group (II). The patients underwent 3 consecutive ovarian hyperstimulation (Clomiphen citrate and human menopausal gonadotropin) and IUI cycles. The main outcome measurements were the CPRs per patients for 3 consecutive stimulated IUI cycles.
Results: Cycle characteristics were found to be homogenous between the both groups. CPRs were similar in group І (26.6%) and group II (28%) (p=0.87; OR=1.075; 95% CI: 0.57 -2.28).
Conclusion: Unilateral tubal blockage (diagnosed on HSG) has no effect on success rate of stimulated IUI cycles, so COH and IUI could be recommended as the initial therapeutic protocol in these patients.
Objective: To evaluate the effect of unilateral tubal blockage diagnosed by HSG on cumulative pregnancy rate (CPR) of the stimulated IUI cycles.
Materials and Methods: A cross-sectional analysis was performed between October 2006 and October 2009 in an academic reproductive endocrinology and infertility center. Two groups of patients undergoing stimulated IUI cycles were compared. Sixty-four infertile couples with unilateral tubal blockage diagnosed by HSG as the sole cause of infertility in the group (І), and two hundred couples with unexplained infertility in the group (II). The patients underwent 3 consecutive ovarian hyperstimulation (Clomiphen citrate and human menopausal gonadotropin) and IUI cycles. The main outcome measurements were the CPRs per patients for 3 consecutive stimulated IUI cycles.
Results: Cycle characteristics were found to be homogenous between the both groups. CPRs were similar in group І (26.6%) and group II (28%) (p=0.87; OR=1.075; 95% CI: 0.57 -2.28).
Conclusion: Unilateral tubal blockage (diagnosed on HSG) has no effect on success rate of stimulated IUI cycles, so COH and IUI could be recommended as the initial therapeutic protocol in these patients.
Type of Study: Original Article |
References
1. Evert JL. Female subfertility, Lancet 2002; 360:151-159. [DOI:10.1016/S0140-6736(02)09417-5]
2. National Institue for Clinical Excellence. Fertility: Assessment and Treatment for People with Fertility problem. Full Guideline 2002, RCOG press, London.
3. Cheong YC, Li TC, Evidence-based management of tubal disease and infertility. Current Obstet Gynecol 2005; 15: 306-313. [DOI:10.1016/j.curobgyn.2005.07.005]
4. Mol BW, Collin JA, Van Der Veen F, Bossuryt PM. Cost-effectiveness of hysterosalpingography, laparoscopy and Chlamydia antibodies testing in subfertile couples. Fertil Steril 2001; 75: 571-580. [DOI:10.1016/S0015-0282(00)01748-9]
5. Swart P, Mol BW, Van der veen F. The accuracy of hysterosalpingography and diagnosis of tubal pathology: a meta-analysis, Fertil Steril 1995, 64: 486-891. [DOI:10.1016/S0015-0282(16)57781-4]
6. Feyez JA, Mutie G, Schneider PJ. The diagnostic value of hysterosalpingography and laparoscopy in infertility investigation.Int J Fertil 1988; 33: 98-101.
7. Hutchins CJ, Laparoscopy and hysterosalpingography in the assessment of tubal patency. Obstet Gynecol 1997; 49:325-327.
8. Karasick S, Goldfarb AF. Peritubal adhesion in infertile women: diagnosis with hysterosalpingography. Am J Rentgenol 1989; 152:777-779. [DOI:10.2214/ajr.152.4.777]
9. Tanahatoe S, Lambalk CB, Hompes PGA. The role of laparoscopy in intrauterine insemination: a prospective randomized reallocation study. Hum Reprod 2005; 20: 3225-3230. [DOI:10.1093/humrep/dei201]
10. Lavy Y, Lev-sagie A, Holtzer H, Revel A, Hurwitz A. Should laparoscopy be a mandatory component of the infertility evaluation in infertile women with normal hysterosalpingography or suspected unilateral tubal pathology? European J OB &GYN 2004; 114:64-68.
11. Fatum M, Laufer N, Simon A. Should diagnostic laparoscopy be performed after normal hysteroscopy in treating infertility suspected to be unknown origin? Hum Reprod 2002; 17:1-3. [DOI:10.1093/humrep/17.1.1]
12. The ESHRE Capri Workshop Group. Optimal use of infertility diagnostic tests and treatment. Hum Reprod 2000; 15: 723-732. [DOI:10.1093/humrep/15.3.723]
13. Honore GM, Holden AEC, Schenken RS, Pathophysiology and management of proximal tubal blockage. Fertil Steril 1999; 71: 785-795. [DOI:10.1016/S0015-0282(99)00014-X]
14. Papaioannou S, A hypothesis for the pathogenesis and natural history of proximal tubal blockage. Hum Reprod 2004; 19: 481-485. [DOI:10.1093/humrep/deh111]
15. Dchaud H, Reyftmann L, Faidherbe J, Hamamah S, Hedon B. Evidence-based reproductive surgery: tubal infertility . International Congress Series 2004; 1266: 96-100. [DOI:10.1016/j.ics.2004.01.117]
16. Coppus SFPG, Steures P, Van der steeg JW, Hompes PG A, Van der veen F, Mol BWJ. Unilateral tubal pathology on hysterosalpingography or diagnostic laparoscopy does not have prognostic significance for treatment – independent pregnancy at 12 months follow-up. Fertil Steril 2007; 88:s191. [DOI:10.1016/j.fertnstert.2007.07.657]
17. Mol BWJ, Swart P, Bossuyt P, Van der veen F. Is hysterosalpingography an important tool in predicting fertility outcome? Fertil Steril 1997:67; 663-669. [DOI:10.1016/S0015-0282(97)81363-5]
18. Nordenskjold F, Ahlgren M. Laparoscopy in female infertility. Acta Obstet Gynecol Scand 1983; 62: 609-615. [DOI:10.3109/00016348309156258]
19. Farhi J, Ben-Haroush A, Lande Y, Fish B. Role of treatment with ovarian stimulation and intrauterine insemination in women with unilateral tubal occlusion diagnosed by hysterosalpingography. Fertil Steril 2007; 88:396-400. [DOI:10.1016/j.fertnstert.2006.11.187]
20. World Health Organization, Laboratory manual of the examination of human semen and sperm-mucus interaction, Cambridge, University Press, Cambridge, U.K; 1992.
21. American Fertility Society. Intervention of the infertile couple. Birmingham, AL: American Fertility Society; 1992
22. Rowe PJ, Comhaire FA, Hargreave TB, Mahmoud AMA. WHO, Manual for the standardized investigation of infertile couples. Cambridge, U K, Cambridge University, Press; 1993.
23. Chapron C, Querieu D, Bruhat MA, Madelenat P, Frenandez H, Pierre F, Dubuisson JB, Surgical complications of diagnostic and operative gynecological laparoscopy: a series of 29966 cases. Hum Reprod 1998; 13:867-872. [DOI:10.1093/humrep/13.4.867]
24. Gutmann JN, Emaging in the evaluation of female infertility. J Reprod Med 1992; 37; 54-61.
25. Parazzini F, Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women: a randomized trial. Hum Reprod 1999; 14: 1332-1334. [DOI:10.1093/humrep/14.5.1332]
26. Marcoux S, Maheux R, Berube S. Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med 1997; 337:217-222. [DOI:10.1056/NEJM199707243370401]
27. Simon A, Laufer N. Unexplained infertility: a reappraisal. Ass Reprod Rev 1993; 3: 3026-36.
28. Mol BW, Dijkman B, Wertheim P, Lijmer J, Van der veen F, Bossuy PM, The accuracy of serum Chlamydia antibodies in the diagnosis of tubal pathology: a meta-analysis . Fertil Steril 1997; 67: 1031-1037. [DOI:10.1016/S0015-0282(97)81435-5]
29. Mol B W, Collins J A, BurrowEA, Van der veen F, Bossoyt P M. Comprison of hysterosalpingography and laparoscopy in predicting fertility outcome. Hum Reprod 1999; 14: 1237-1242. [DOI:10.1093/humrep/14.5.1237]
30. Dessole S, Battista G, Capobianco G, Menzoni MA, Ambrosini G, Canalis GC. A second hysterosalpingography reduce the use of selective technique for treatment of a proximal tubal obstruction. Fertil Steril 2000; 73: 1037-1039. [DOI:10.1016/S0015-0282(00)00415-5]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
