Evaluation of intrauterine insemination practices: a 1-year prospective study in seven French assisted reproduction technology centers

Monraisin, Oriana; Chansel‐Debordeaux, Lucie; Chiron, A.; Floret, Sébastien; Cens, Steven; Bourrinet, Sylvain; Paulhac, Sophie; Jimenez, C.; Parinaud, Jean; Léandri, Roger

doi:10.1016/j.fertnstert.2016.01.039

Cited by 23 publications

(32 citation statements)

References 27 publications

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“…In all #bib23 studies were assessed for eligibility. Eight studies were subsequently excluded after the examination of full‐text: two studies were not RCT . Ragni et al aimed to evaluate the luteal phase profile in women undergoing IUI‐stimulated cycles with/without GnRH‐ant.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies were subsequently excluded after the examination of full-text: two studies were not RCT. 16,17 Ragni et al 13 aimed to evaluate the luteal phase profile in women undergoing IUI-stimulated cycles with/without GnRH-ant. Two studies evaluated the effectiveness of different stimulation protocols in women receiving gonadotrophins plus GnRH-ant before IUI.…”

Section: Study Selectionmentioning

confidence: 99%

See 1 more Smart Citation

Pituitary block with gonadotrophin‐releasing hormone antagonist during intrauterine insemination cycles: a systematic review and meta‐analysis of randomised controlled trials

Vitagliano

Saccone

Noventa

et al. 2018

BJOG

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Section: Resultsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Pituitary block with gonadotrophin‐releasing hormone antagonist during intrauterine insemination cycles: a systematic review and meta‐analysis of randomised controlled trials

Vitagliano

Saccone

Noventa

et al. 2018

BJOG

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“…Also, in a study by Oriana et al [15] where 707 patients entering the program to determine the best practice of IUI with partner's fresh sperm showed that the use of GnRH antagonist has a positive effect on delivery rate, particularly in the multifollicular stimulation.…”

Section: Discussionmentioning

confidence: 99%

“…However, the number of follicles recruited must be adjusted to the woman's age to limit the risk of multiple pregnancies as in young age the risk of multiple pregnancies is high even with bifollicular recruitment [15].…”

Section: Discussionmentioning

confidence: 99%

The Use of Gonadotropin Releasing Hormone Antagonist in Women Undergoing Intrauterine Insemination

My¹,

Bs²

2018

Arch Med

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“…For example, the ovarian stimulation protocols vary from one study to another, especially with the use of GnRH antagonists which have been reported to have a huge impact on IUI results (Luo et al, 2014). Indeed, GnRH antagonists allow to have multi-follicular recruitment as well as a better synchronization between ovulation and insemination, which could be crucial in case of sperm deficiency (Monraisin et al, 2016).…”

Section: Dear Editormentioning

confidence: 99%

Does the 18‐h sperm motility influence intrauterine insemination results?

et al. 2018

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Dear Editor Sperm quality has a major influence on the results of intrauterine inseminations (IUI), especially through the number of motile spermatozoa recovered after preparation and their morphology (Wainer et al., 2004). Another sperm parameter reported to impact IUI results was sperm motility after 18 h or 24 h incubation (so-called sperm survival by approximation) in culture media after preparation with a drop in pregnancy rate from 21% if survival is >70% to less than 4% when it is ≤70% (Branigan et al., 1999). However, there is no recent data on this subject and in their systematic review on the effect of semen quality on IUI results, Ombelet et al. have found no other paper on sperm survival since the one of Branigan et al. published in 1999(Ombelet et al., 2014. Therefore, we aimed to revisit the concept of a deleterious impact of low sperm survival on IUI outcome.The study included 1793 consecutive IUI performed in 713 couples at the Toulouse university hospital from January 1, 2012 to December 31, 2016. Ovarian stimulation used a combination of recombinant FSH and GnRH antagonist. Ovulation was induced by injection of recombinant hCG when at least one follicle ≥18 mm was obtained. Insemination was performed 36 h after hCG injection. Clinical pregnancies were defined as the presence of a fetal heartbeat seven weeks after insemination.Semen analysis was performed within six months before the first IUI. After conventional analysis (volume, concentration, and motility), spermatozoa were prepared according to WHO 2010 using discontinuous density gradient centrifugation (three layers: 60%, 80%, 90%) (Puresperm â , Nidacon, M€ olndal, Sweden). After preparation, spermatozoa were incubated in 400 lL universal IVF medium (Origio, Versailles, France) at 37°C in a 6% CO 2 atmosphere. Motility was assessed after a 18 h incubation.Sperm preparation on the day of IUI was performed in the same way.The clinical pregnancy rate per attempt was not different according to the 18 h motility classes (defined by centiles) (13.4% for motility <25%, 15.5% for 25% < motility < 45%, 12.1% for 45% < motility < 60%, 15.0% for 60% < motility < 70%, 15.3% for 70% < motility < 80%, and 16.5% for motility ≥ 80%; NS).This finding is opposite to the results published by Branigan et al., who reported a pregnancy rate per cycle lower than 4% when the motility after a 24 h incubation was lower than 70%. However, the proportion of low survival rate (<20%) is much lower in our study (<10%) than in their study (Table 1) (36%) although they adjusted sperm concentration to a maximum of 10 millions motile sperm per milliliter for evaluating sperm survival which should have help maintain it. This difference could reflect discrepancies in the treated population and/or in techniques. Indeed, in the 20 years between the two studies, numerous modifications have been carried out concerning gradient as well as media. It must be pointed out that in the Table 1 Demographic data and IUI results according to sperm motility after a 18 h incubation 18 h mot...

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Evaluation of intrauterine insemination practices: a 1-year prospective study in seven French assisted reproduction technology centers

Abstract: Our results indicate that the use of GnRH antagonists has a positive effect on the delivery rate, especially in the multifollicular stimulations that are required when women are older than 27 years.

Cited by 23 publications

References 27 publications

Pituitary block with gonadotrophin‐releasing hormone antagonist during intrauterine insemination cycles: a systematic review and meta‐analysis of randomised controlled trials

Pituitary block with gonadotrophin‐releasing hormone antagonist during intrauterine insemination cycles: a systematic review and meta‐analysis of randomised controlled trials

The Use of Gonadotropin Releasing Hormone Antagonist in Women Undergoing Intrauterine Insemination

Does the 18‐h sperm motility influence intrauterine insemination results?

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