Volume 11, Issue 3 (5-2013)                   IJRM 2013, 11(3): 227-0 | Back to browse issues page

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Yavuz A, Demirci O, Sözen H, Uludoğan M. Predictive factors influencing pregnancy rates after intrauterine insemination. IJRM 2013; 11 (3) :227-0
URL: http://ijrm.ir/article-1-394-en.html
Predictive factors influencing pregnancy rates after intrauterine insemination
Arzu Yavuz * 1, Oya Demirci2 , Hamdullah Sözen2 , Mehmet Uludoğan2
1- Department of Obstetrics and Gynecology, Zeynep Kamil Gynecologic and Pediatric Training Research Hospital, 34668, İstanbul, Turkey , demircioya@gmail.com
2- Department of Obstetrics and Gynecology, Zeynep Kamil Gynecologic and Pediatric Training Research Hospital, 34668, İstanbul, Turkey
Abstract:   (3212 Views)
Background: So far, many studies investigated factors that affect pregnancy rates after intrauterine insemination (IUI). Various investigators have not agreed on the nature and ranking of these criteria.
Objective: The aim of this study was to assess the predictive factors for pregnancy rate after controlled ovarian hyperstimulation (COH)/ IUI.
Materials and Methods: Retrospective study of all patients undergoing IUI at Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital from January 2006 to December 2009. In total 980 IUI cycles in 569 couples were analyzed. All women in the study underwent ovarian stimulation using gonadotropin and IUI was performed 36 h after triggering ovulation. The primary outcome measure was clinical pregnancy rates. Predictive factors evaluated were female age, body mass index (BMI), duration of infertility, type of infertility, follicle stimulating hormone (FSH) level and estradiol (E2) on third day of the cycle, number of preovulatory follicles, endometrial thichness, total motil sperm (TMS) count, and ratio of progressive motile sperm.
Results: The overall clinical pregnancy rate was 4.7%. Among the predictive factors after multivariate logistic regression analysis level of BMI (<25 kg/m²), number of preovulatory follicles (≥2), level of FSH (<9.4 IU/L), level of E2 (<80 pg/ml) and the ratio of progressive motile sperm (>50%) significantly influenced the clinical pregnancy rate.
Conclusion: Level of BMI, FSH, estradiol, number of preovulatory follicles and the ratio of progressive motile sperm may determine IUI procedure as optimum treatment model.
Keywords: Intrauterine insemination, Pregnancy rate, Predictive factor, Gonadotropin, Progressive motile spermatozoa.
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Type of Study: Original Article |
References
1. Cantineau AE, Cohlen BJ, Al-Inany H, Heineman MJ. Intrauterine insemination versus fallopian tube sperm perfusion for non tubal infertility. Cochrane Database Syst Rev 2004; CD001502.
2. Dorjpurev U, Kuwahara A, Yano Y, Taniguchi T, Yamamoto Y, Suto A, et al. Effect of semen characteristics on pregnancy rate following intrauterine insemination. J Med Invest 2011; 58: 127-133. [DOI:10.2152/jmi.58.127]
3. Grigoriou O, Pantos K, Makrakis E, Hassiakos D, Konidaris S, Creatsas G. Impact of isolated teratozoospermia on the outcome of intrauterine insemination. Fertil Steril 2005; 83: 773-775. [DOI:10.1016/j.fertnstert.2004.08.027]
4. Merviel P, Heraud MH, Grenier N, Lourdel E, Sanguinet P, Copin H. Predictive factors for pregnancy after intrauterine insemination (IUI): an analysis of 1038 cycles and a review of the literature. Fertil Steril 2010; 93: 79-88. [DOI:10.1016/j.fertnstert.2008.09.058]
5. Wainer R, Albert M, Dorion A, Bailly M, Bergère M, Lombroso R, et al. Influence of the number of motile spermatozoa inseminated and of their morphology on the success of intrauterine insemination. Hum Reprod 2004; 19: 2060-2065. [DOI:10.1093/humrep/deh390]
6. Ibérico G, Vioque J, Ariza N, Lozano JM, Roca M, Llácer J, et al. Analysis of factors influencing pregnancy rates in homologous intrauterine insemination. Fertil Steril 2004; 81: 1308-1313. [DOI:10.1016/j.fertnstert.2003.09.062]
7. Steures P, van der Steeg JW, Mol BW, Eijkemans MJ, van der Veen F, Habbema JD, et al. Prediction of an ongoing pregnancy after intrauterine insemination. Fertil Steril 2004; 82: 45-51. [DOI:10.1016/j.fertnstert.2003.12.028]
8. Nuojua-Huttunen S, Tomas C, Bloigu R, Tuomivaara L, Martikainen H. Intrauterine insemination treatment in subfertility: an analysis of factors affecting outcome. Hum Reprod 1999; 14: 698-703. [DOI:10.1093/humrep/14.3.698]
9. Esmailzadeh S, Faramarzi M. Endometrial thickness and pregnancy outcome after intrauterine insemination. Fertil Steril 2007; 88: 432-437. [DOI:10.1016/j.fertnstert.2006.12.010]
10. Wang JX, Warnes GW, Davies MJ, Norman RJ. Overweight infertile patients have a higher fecundity than normal-weight women undergoing controlled ovarian hyperstimulation with intrauterine insemination. Fertil Steril 2004; 81: 1710-1712. [DOI:10.1016/j.fertnstert.2003.10.037]
11. Dodson WC, Kunselman AR, Legro RS. Association of obesity with treatment outcomes in ovulatory infertile women undergoing superovulation and intrauterine insemination. Fertil Steril 2006; 86: 642-646. [DOI:10.1016/j.fertnstert.2006.01.040]
12. Norman RJ, Clark AM. Obesity and reproductive disorders: a review. Reprod Fertil Dev 1998; 10: 55-63. [DOI:10.1071/R98010]
13. Pettigrew R, Hamilton-Fairley D. Obesity and female reproductive function. Br Med Bull 1997; 53: 341-358. [DOI:10.1093/oxfordjournals.bmb.a011617]
14. Bray GA. Obesity and reproduction. Hum Reprod 1997; 12 (Suppl.): 26-32.
15. Loveland JB, McClamrock HD, Malinow AM, Sharara FI. Increased body mass index has a deleterious effect on in vitro fertilization outcome. J Assist Reprod Genet 2001; 18: 382-386. [DOI:10.1023/A:1016622506479]
16. Mullin CM, Virji N, Saketos M, San Roman G. Day 2 follicle stimulating hormone and estradiol: could these values be used as markers to predict pregnancy outcomes in women undergoing ovulation induction therapy with intrauterine insemination cycles? Fertil Steril 2004; 84: S162.
17. Dickey RP, Taylor SN, Lu PY, Sartor BM, Rye PH, Pyrzak R. Effect of diagnosis, age, sperm quality, and number of preovulatory follicles on the outcome of multiple cycles of clomiphene citrate-intrauterine insemination. Fertil Steril 2002; 78: 1088-1095. [DOI:10.1016/S0015-0282(02)04212-7]
18. Miller DC, Hollenbeck BK, Smith GD, Randolph JF, Christman GM, Smith YR, et al. Processed total motile sperm count correlates with pregnancy outcome after intrauterine insemination. Urology 2002; 60: 497-501. [DOI:10.1016/S0090-4295(02)01773-9]
19. Van Voorhis BJ, Barnett M, Sparks AE, Syrop CH, Rosenthal G, Dawson J. Effect of the total motile sperm count on the efficacy and cost-effectiveness of intrauterine insemination and in vitro fertilization. Fertil Steril 2001; 75: 661-668. [DOI:10.1016/S0015-0282(00)01783-0]
20. Kang BM, Wu TC. Effect of age on intrauterine insemination with frozen donor sperm. Obstet Gynecol 1996; 88: 93-98. [DOI:10.1016/0029-7844(96)00074-9]
21. Yousefi B, Azargon A. Predictive factors of intrauterine insemination success of women with infertility over 10 years. J Pak Med Assoc 2011; 61: 165-168.
22. Kolibianakis EM, Zikopoulos KA, Fatemi HM, Osmanagaoglu K, Evenpoel J, Van Steirteghem A, et al. Endometrial thickness cannot predict ongoing pregnancy achievement in cycles stimulated with clomiphene citrate for intrauterine insemination. Reprod Biomed Online 2004; 8: 115-118. [DOI:10.1016/S1472-6483(10)60505-6]
23. Yaman C, Ebner T, Jesacher K, Sommergruber M, Radner G, Tews G. Sonographic measurement of endometrium thickness as a predictive value for pregnancy through IVF. Ultraschall Med 2002; 23: 256-259. [DOI:10.1055/s-2002-34053]
24. Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod 2003; 18: 2337-2341. [DOI:10.1093/humrep/deg461]
25. Noyes N, Liu HC, Sultan K, Schattman G, Rosenwaks Z. Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilization. Hum Reprod 1995; 10: 919-922. [DOI:10.1093/oxfordjournals.humrep.a136061]
26. Goverde AJ, McDonnell J, Vermeiden JP, Schats R, Rutten FF, Schoemaker J. Intrauterine insemination or in-vitro fertilisation in idiopathic subfertility and male subfertility: a randomised trial and cost-effectiveness analysis. Lancet 2000; 355: 13-18. [DOI:10.1016/S0140-6736(99)04002-7]
27. Erdem A, Erdem M, Atmaca S, Korucuoglu U, Karabacak O. Factors affecting live birth rate in intrauterine insemination cycles with recombinant gonadotrophin stimulation. Reprod Biomed Online 2008; 17: 199-206. [DOI:10.1016/S1472-6483(10)60195-2]
28. van Noord-Zaadstra BM, Looman CW, Alsbach H, Habbema JD, te Velde ER, Karbaat J. Delaying childbearing: effect of age on fecundity and outcome of pregnancy. BMJ 1991; 302: 1361-1365. [DOI:10.1136/bmj.302.6789.1361]
29. Tomlinson MJ, Amissah-Arthur JB, Thompson KA, Kasraie JL, Bentick B. Prognostic indicators for intrauterine insemination (IUI): statistical model for IUI success. Hum Reprod 1996; 11: 1892-1896. [DOI:10.1093/oxfordjournals.humrep.a019513]
30. Mathieu C, Ecochard R, Bied V, Lornage J, Czyba JC. Cumulative conception rate following intrauterine artificial insemination with husband's spermatozoa: influence of husband's age. Hum Reprod 1995; 10: 1090-1097. [DOI:10.1093/oxfordjournals.humrep.a136100]
31. Khalil MR, Rasmussen PE, Erb K, Laursen SB, Rex S, Westergaard LG. Homologous intrauterine insemination. An evaluation of prognostic factors based on a review of 2473 cycles. Acta Obstet Gynecol Scand 2001; 80: 74-81. [DOI:10.1080/791201839]
32. Brzechffa PR, Daneshmand S, Buyalos RP. Sequential clomiphene citrate and human menopausal gonadotrophin with intrauterine insemination: the effect of patient age on clinical outcome. Hum Reprod 1998; 13: 2110-2114. [DOI:10.1093/humrep/13.8.2110]
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