A comparative analysis of the cycle fecundity rates associated with combined human menopausal gonadotropin (hMG) and intrauterine insemination (IUI) versus either hMG or IUI alone

Chaffkin, Linda M.; Nulsen, John; Luciano, Anthony A.; Metzger, Déborah

doi:10.1016/0020-7292(92)90995-u

Cited by 61 publications

(60 citation statements)

References 22 publications

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“…In study of Chafkin LM, Nulsen JC, Luciano AA et al recommended a maximum three trial of COH/IUI, based on cycle fecundity cumulative pregnancy rates observed in historical controls involving 594 patients of unexplained infertility. 7 Thus benefit of continuing COH/IUI treatment beyond three cycles appears to be minimal.…”

Section: Discussionmentioning

confidence: 99%

Factors determining successful intrauterine insemination

Sinha

Pandey

Srivastava

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Infertility is defined as failure to conceive even after one year of regular, frequent and unprotected intercourse. Infertility can be attributed to male causes in approximately 25-40% cases, female causes in 40-50% cases, both in 10-20% and unexplained causes in 10-15% cases. Artificial insemination (Intrauterine Insemination) involves placement of processed sperms from husband (AIH – artificial insemination homologous) or from donor (AID – artificial insemination donor) into the female genital tract.Methods: Objectives of the study were to do sperm preparation to obtain normal good quality motile sperms, to perform intrauterine insemination using husband semen around the time of ovulation, to study factors responsible for successful pregnancy rates by this method. Out of 100 infertile females recruited for the study 34 underwent artificial insemination by IUI with controlled ovarian hyper stimulation. Sperms were washed by density gradient centrifugation or by a direct swim-up technique that does not involve centrifugation.Results: Overall pregnancy rate per patient for male factor infertility was 23.52%. None of the patients consented for more than three cycles of IUI. Maximum pregnancy was achieved in third cycle of IUI. Sperm motility >40% was related with pregnancy in 8 cases. Duration of infertility didn’t influence pregnancy rate. The majority of pregnancies were achieved in the age group of 25-29 years (50%). No pregnancy occurred with >15 years of infertility.Conclusions: This study concluded that intrauterine insemination after ovarian stimulation or controlled ovarian hyperstimulation is a successful and efficacious therapy for infertility.

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Section: Discussionmentioning

confidence: 99%

Factors determining successful intrauterine insemination

Sinha

Pandey

Srivastava

2017

Int J Reprod Contracept Obstet Gynecol

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“…Some studies have reported a modest benefit of IUI in women with minimal and mild endometriosis [51][52][53][54][55] (Table 2). In particular, IUI with controlled ovarian stimulation (COS) resulted in increases in pregnancy rate compared with expectant management in a few large RCTs and in a large population study [56][57][58].…”

Section: Assisted Reproductive Technology In Women With Endometrimentioning

confidence: 99%

Management of Endometriosis-Associated Infertility

2014

J Androl Gynaecol

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Endometriosis is a common, chronic disease. Patients typically present with pelvic pain, infertility, and/or an adnexal mass. Results from the limited number of studies that have been published indicate that the true prevalence of endometriosis, along with the associated infertility, has been increasing. Debates about infertility management arise from the contradiction between the contraceptive nature of medical treatments for endometriosis and the unpredictable ovarian reserve after surgery. There is moderate quality evidence that surgery increases clinical pregnancy rate and live birth in minimal to mild endometriosis. However, insufficient evidences which supports the effect of surgery in moderate to severe endometriosis in term of subfertility. On this basis, artificial reproductive technologies have been become the most efficient way of overcoming endometriosisassociated infertility, particularly in stage III/IV endometriosis. The objective of this paper is to review recent trends in endometriosis, from the pathophysiology of the disease to the management of infertility.endometriosis and infertility and to assess the current approaches and management modalities used for infertile women with endometriosis. PathophysiologyAs previously mentioned, how endometriosis contributes to infertility remains controversial. However, there are a few hypotheses that describe the pathophysiology of endometriosis-associated infertility when the endometriotic lesion is located in the pelvic cavity, ovary, or uterus [8]. Distorted Pelvic AnatomyPelvic adhesions that develop as a consequence of endometriosis can interfere with ovulation, transport of the oocyte or ovum, and pick-up by the fimbriae. The oviducts may be patent bilaterally, but existing adhesions around the adnexa can interrupt the dynamic movements of the fimbriae that are necessary for oocyte uptake [9]. Altered Peritoneal MilieuThe chronic inflammatory status of the pelvic cavity in endometriosis patients has been recognized for decades. This inflammation is accompanied by increased infiltration of macrophages in the pelvic fluid. The pathophysiology has not been well-described, but increased recruitment of immune cells and dysregulated apoptosis of endometrial cells present in the lesion are thought to be contributing factors. Additional support for this hypothesis arises from the observation that in addition to the macrophages, inflammatory cytokines, and prostaglandins, chemokines stimulate and aggregate monocytes and granulocytes. RANTES [10], monocyte inflammatory protein-1 [11,12] IntroductionEndometriosis is a disease characterized by ectopic endometrial glands and stromal tissue external to the uterine cavity. The prevalence of the disease has been reported to be 5-10% in women of reproductive age, 20-30% in women diagnosed with infertility, and 40-60% in women with chronic pelvic pain [1]. Fecundity, the probability of giving live birth in a menstrual cycle, has been shown to be 0.02-0.1 per month in women with endometriosis, but is 0.15-0.2 ...

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“…Es posible que los beneficios de estos tratamientos también se extiendan a las mujeres con enfermedad avanzada, si sus trompas son permeables y si las adherencias se han resecado quirúrgicamente. Las tasas de embarazo por ciclo, parecen que disminuyen significativamente después de tres o cuatro ciclos de de clomifeno más IIU; por lo tanto, después de tres o cuatro ciclos el clínico debe pasar a las inyecciones de gonadotropina más IIU (74)(75)(76). El principal inconveniente de este enfoque es el aumento de la tasa de gestaciones múltiples, observándose hasta un 20% de embarazos gemelares.…”

Section: Clomifeno Más Iiuunclassified

Endometriosis, endometrioma e infertilidad

Restrepo

2010

Rev. Med.

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ResumenLa endometriosis es una enfermedad ginecológica frecuente y puede ocasionar dolor pélvico; es una de las causas de infertilidad aunque en un pequeño pero significativo porcentaje y se observa hasta en el 50% de las laparoscopias de las pacientes en estudio de infertilidad. Sobre su patogénesis se conoce poco; sin embargo, actualmente existen varias teorías que tratan de explicar su presentación, sin obviar los factores genéticos que pueden hacer a las mujeres susceptibles a esta entidad. Los mecanismos que explican su fisiopatología en la infertilidad son la obstrucción tubárica, las adherencias pélvicas y los endometriomas ováricos que distorsionan las relaciones anatómicas y limitan el acceso y movilidad de las fimbrias al ovario. El método más utilizado para el diagnóstico de la endometriosis es la ecografía. Este artículo presenta una revisión de la literatura sobre la fisiopatología, la etiología, el cuadro clínico, el diagnóstico y el tratamiento de la endometriosis y los endometriomas en el área de la infertilidad. Palabras clave: endometrioma, infertilidad, endometriosis ENDOMETRIOSIS, ENDOMETRIOMA AND INFERTILITY AbstractEndometriosis is a common gynecological disease and can cause pelvic pain and infertility; although the latest represent a small but significant percentage of up to 50% of the testing female infertility using laparoscopy. Its pathogenesis is poorly understood though several theories are now offered which attempt to explain its appearance, such as genetic factors that could make women susceptible to this entity. The mechanisms that explain the pathophysiology of infertility are tubal blockage, pelvic adhesions and ovarian endometriomas distort anatomic relationships and limit access and mobility of the fimbriae to the ovary. The most widely used method for diagnosis of endometriomas is ultrasound. This article presents a literature review on the pathophysiology, aetiology, clinical manifestations, diagnosis and treatment of endometriosis and endometriomas in the area of infertility.

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A comparative analysis of the cycle fecundity rates associated with combined human menopausal gonadotropin (hMG) and intrauterine insemination (IUI) versus either hMG or IUI alone

Cited by 61 publications

References 22 publications

Factors determining successful intrauterine insemination

Factors determining successful intrauterine insemination

Management of Endometriosis-Associated Infertility

Endometriosis, endometrioma e infertilidad

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