Showing 9 results for Intrauterine Insemination
Sanam Moradan,
Volume 7, Issue 1 (7-2009)
Abstract
Background: Pelvic inflammatory disease is one of the most serious infection and one of the important and life threatening complications of it is tubo-ovarian abscess. This infection with intrauterine insemination (IUI) is rare. We report a case of ruptured tubo- ovarian abscess after (IUI).
Case: A 27 years old woman was referred to our center with acute abdominal pain and fever one week after IUI. The diagnosis was PID and after treatment with intravenous antibiotics she was still febrile after 3days and had generalized tenderness in abdominal exam. Therefore, laparatomy was performed and left fallopian tube ruptured abscess was detected. Left salpingectomy was done. The patient developed dyspnea and tachypnea in second day post operation and echocardiography with spiral CT scan was normal. So a mild ARDS was considered .The patient was discharged from hospital 5 days after operation in good condition.
Conclusion: This is a case of PID, tubal abscess and ARDS after IUI and it is necessary to keep in mind this diagnosis after IUI.
Victoria Habibzadeh, Sayed Noureddin Nematolahi Mahani, Hadiss Kamyab,
Volume 9, Issue 1 (7-2011)
Abstract
Background: Many studies have been carried out to understand the effect of endometrial thickness on the reproductive outcome while the factors affecting the pattern itself are still unknown.
Objective: To determine the factors such as age and the number of follicles that could affect the endometrial thickness
Materials and Methods: This study was conducted as a retrospective study on 680 infertile women considered for intrauterine insemination (IUI). IUI protocol was sequential regimen of clomid and gonadotropin. Endometrial thickness measurement was done on the day of HCG administration. Correlation between endometrial thickness and factors such as age, total follicle numbers, dominant follicle numbers, gonadotropine ampule numbers and pregnancy rate were assessed.
Results: The mean endometrial thickness was 7.2±1.8 mm. The endometrium was thinner in older patients compared with younger ones. But in all age ranges pregnancy rate was higher in endometrial thickness 6< ET≤10 mm (p<0.05).
Conclusion: We did not find any correlation between age, number of follicles and gonadotropine ampoules with endometrial thickness but in all age ranges, there is a possibility of higher chance of pregnancy in endometrial thickness 6 < ET≤10 mm.
Mahbod Ebrahimi , Firoozeh Akbari Asbagh, Azizeh Ghaseminejad,
Volume 9, Issue 1 (7-2011)
Abstract
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.
Arzu Yavuz, Oya Demirci, Hamdullah Sözen, Mehmet Uludoğan,
Volume 11, Issue 3 (5-2013)
Abstract
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.
Bibi Shahnaz Aali, Sakineh Ebrahimipour, Siavash Medhdizadeh,
Volume 11, Issue 4 (6-2013)
Abstract
Background: Controlled ovarian stimulation combined with intra uterine insemination (IUI) is a convenient treatment of infertility with a success rate of 11%. The clinical observation and pattern of progesterone secretion in this method is suggestive of luteal phase defect and postulated as an implicating factor of treatment failure.
Objective: To investigate the efficacy of luteal phase support with intravaginal cyclogest in women undergoing controlled ovarian stimulation combined with intrauterine insemination.
Materials and Methods: In this single-blinded clinical trial, 196 consecutively seen women eligible for the study protocol, were randomized to receive either intravaginal progesterone (cyclogest pessary, Actavis) or no medication in luteal phase. Blood samples were collected and serum progesterone level in 7th and 11th day of the cycle, biochemical and clinical pregnancy and luteal phase duration were compared in case and control groups.
Results: The mean age in case and control group was 28 and 27.9 years, respectively and the most frequent cause of infertility was unexplained. Additionally, ovulatory dysfunction was the most common cause of female infertility in both groups. Based on these variables, there was no statistically significant difference between the two groups. Mean serum progesterone level in the case group were 48.34 and 34.24nmol/day on day 7 and 11 after insemination, respectively and both values were significantly higher than the control group. There was no difference between the two groups in terms of biochemical and clinical pregnancy. Luteal phase duration in the case group was significantly longer than the control group.
Conclusion: Luteal phase support by Cyclogest pessary increases progesterone level and prolongs the luteal phase, but does not affect success rate of IUI cycles in terms of achieving pregnancy.
Afsoon Zarei, Saeed Alborzi, Nasrin Dadras, Ghazal Azadi,
Volume 12, Issue 9 (10-2014)
Abstract
Background: Implantation is considered as the rate-limiting step in success of assisted reproduction techniques, and intrauterine insemination cycles. It might be affected by ovarian superovulation and endometrial local scratching.
Objective: This study aims to investigate the effect of local endometrial injury on the outcome of IUI cycles.
Materials and Methods: In this randomized clinical trial 144 women with unexplained infertility, mild male factor, and mild endometriosis randomly divided into two study groups through block randomization. The patients were randomly assigned to undergo endometrial biopsy between days 6-8 of the previous menstrual cycle before IUI (n=72, IUI cycles =126) or receive no interventions (n=72, IUI cycles=105).
Results: The pregnancy rate per patient was 17 (23.6%) and 14 (19.4%) in endometrial biopsy and control groups, respectively (p=0.686). The pregnancy rate per cycle was 17/126 (13.5%) and 14/105 (13.3%) in endometrial biopsy and control groups, respectively (p=0.389). The abortion rate was comparable between the two groups (6.9% vs. 9.7%; p=0.764). The ongoing pregnancy rate was found to be comparable between the two study groups, as well (16.7% vs. 9.7%; p=0.325). Endometrial thickness (p=0.609) was comparable between the groups; however ER2R was significantly lower in the endometrial biopsy group (p<0.001).
Conclusion: Application of local endometrial injury in the cycle before the IUI cycles is not associated with increased pregnancy rate per patient and per cycle, decreased abortion, and increased endometrial thickness.
Ziba Zahiri Sorouri, Maryan Asgharnia, Ameneh Gholampoor,
Volume 13, Issue 1 (1-2015)
Abstract
Background: Intrauterine insemination (IUI) is one of the most appropriate and cost-effective methods in infertility treatment.
Objective: We aimed to investigate effect of vaginal misoprostol on pregnancy rate after IUI.
Materials and Methods: Two hundred and ten infertile women who were referred to Infertility Clinic of Alzahra Hospital by an indication of IUI during 2012-2013 were randomly assigned to receive 200 μg vaginal misoprostol (n=105) or vaginal placebo (n=105) after IUI. For detecting pregnancy, past 2 weeks, beta human chorionic gonadotropin evaluation was made and if positive, transvaginal sonography was done for evaluation of pregnancy 2-3 weeks later and clinical pregnancy was recorded.
Results: Pregnancy had been noted in 24 patients in misoprotol (22.9%) and 27 patients in placebo (25.7%) groups that this difference was not significant (p=0.748). In misoprostol group, 3 case of nausea and vomiting (2.9%) had been observed.
Conclusion: According to the results, administering 200 μg vaginal misoprostol after IUI doesn’t have significant effect on the success rate of IUI.
Tahereh Behrouzi Lak, Masoomeh Hajshafiha, Fariba Nanbakhsh, Sima Oshnouei,
Volume 15, Issue 4 (6-2017)
Abstract
Background: N-acetyl cysteine (NAC) was proposed as an adjuvant to clomiphenecitratefor ovulation induction in patients with polycystic ovary syndrome (PCOS)without clomiphene citrate resistance.
Objective: To evaluate the effect of NAC on pregnancy rate in PCOS patients whowere candidates for intrauterine insemination.
Materials and Methods: In this randomized clinical trial 97 PCOS women aged 18-38 years were enrolled in two groups, randomly. For the case group (n=49), NAC(1.2 gr) + clomiphene citrate (100 mg) + letrozole (5mg) were prescribed dailyfromthe third day of menstruation cycle for five days. The control group (n=48) had thesame drug regimen without NAC. In order to follicular development, GONAL-Fwas injected on days of 7-11 menstrual cycles in all participants. When the folliclesize was 18mm or more, HCG (10000 IU) was injected intramuscular and theintrauterine insemination was performed after 34-36 hr.
Results: There was no significant difference between study groups regarding BMI(p=0.28), FSH level (p=0.66), LH level (p=0.67), mean endometrial thickness(p=0.14), mean number of mature follicles (p=0.20) and the pregnancy occurrence(p=0.09).
Conclusion: NAC is ineffective in inducing or augmenting ovulation in PCOSpatients who were candidates for intrauterine insemination and cannot berecommended as an adjuvant to CC in such patients.
Mahnaz Yavangi, Nesa Varmaghani, Azar Pirdeghan, Maryam Varmaghani, Mohammad Faryadras,
Volume 19, Issue 5 (5-2021)
Abstract
Background: Endometrial scratch injury is considered controversial in increasing the success rate of assisted reproductive technology.
Objective: To compare the pregnancy outcomes in women candidated for intrauterine insemination with and without an endometrial scratch.
Materials and Methods: In this randomized clinical trial, 150 women referred to the Fatemieh Hospital, Hamadan, Iran who were candidates for IUI between December 2017 to December 2018 were randomly assigned into two groups (n = 75/each) with or without an endometrial scratch (as case and control groups, respectively). Women in both groups were in the proper and identical protocol for IUI. Chemical and clinical pregnancy, abortion, and live birth rate, also pregnancy complications were compared between the groups.
Results: Chemical and clinical pregnancy rates were higher in the case than the control group (p = 0.25, p = 0.54, respectively). In the case group, the abortion and multiple gestation rates were 14.3% and 4.3%, respectively, while it was 5% in the control group (p = 0.60, p = 0.54 respectively). The endometrium thickness on day 21 was higher in the case group than the control (p = 0.01).
Conclusion: Endometrial scratching in intrauterine insemination women is not associated with an increase in both clinical and clinical pregnancy rates, however, studies with a larger sample size are suggested to evaluate this intervention.
