Comparing the Effectiveness of Doing Intra-uterine Insemination 36 and 42 Hours after Human Chorionic Gonadotropin (HCG) Injection on Pregnancy Rate: A Randomized Clinical Trial

Firouz, Mahboubeh; Noori, Narjes; Ghasemi, Marzieh; Dashipour, Alireza; Keikha, Narjes

doi:10.18502/jfrh.v14i3.4670

Cited by 2 publications

(3 citation statements)

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“…Concerning the oocyte, the ovulation time and its interval to IUI have been studied previously. Although there is still no consensus on the optimal time interval between hCG injection or LH surge and insemination, this interval can be influential on IUI outcomes ( Firouz et al , 2020 ). Several RCTs studying a long versus a short interval between hCG injection and insemination have been published.…”

Section: Discussionmentioning

confidence: 99%

“…Several RCTs studying a long versus a short interval between hCG injection and insemination have been published. Analyzing different short (insemination at the point of hCG and 24 h after hCG) and long (insemination 36 h after hCG and 48 h after hCG) intervals, some of these studies have found comparable pregnancy results between the long and short groups ( Rahman et al , 2011 ; Rijsdijk et al , 2019 ), while others have found better pregnancy outcomes in the long group ( Firouz et al , 2020 ). However, little information is presented about the work-up methods of the semen and/or the time between semen processing and insemination in these studies.…”

Section: Discussionmentioning

confidence: 99%

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A short versus a long time interval between semen collection and intrauterine insemination: a randomized controlled clinical trial

et al. 2023

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STUDY QUESTION Does a short interval (i.e. ≤90 min), compared to a long interval (i.e. ≥180 min), between semen collection and intrauterine insemination (IUI) increase the cumulative chance of an ongoing pregnancy after six IUI cycles? SUMMARY ANSWER A long interval between semen collection and IUI resulted in a borderline significant improvement in cumulative ongoing pregnancies and a statistically significant shorter time to pregnancy. WHAT IS KNOWN ALREADY Retrospective studies assessing the effect of the time interval between semen collection and IUI on pregnancy outcomes have shown inconclusive results. Some studies have indicated a beneficial effect of a short interval between semen collection and IUI on IUI outcomes, while others have not found any differences. To date, no prospective trials have been published on this subject. STUDY DESIGN, SIZE, DURATION The study was performed as a non-blinded, single-center RCT with 297 couples undergoing IUI treatment in a natural or stimulated cycle. The study was conducted between February 2012 and December 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS Couples with unexplained or mild male subfertility and an indication for IUI were randomly assigned for up to six IUI cycles into either the control group (long interval, i.e. 180 min or more between semen collection and insemination) or the study group (short interval, i.e. insemination as soon as possible after semen processing and within 90 min of semen collection). The study was carried out in an academic hospital-based IVF center in the Netherlands. The primary endpoint of the study was ongoing pregnancy rate per couple, defined as a viable intrauterine pregnancy at 10 weeks after insemination. MAIN RESULTS AND THE ROLE OF CHANCE In the short interval group, 142 couples were analyzed versus 138 couples in the long interval group. In the intention-to-treat (ITT) analysis, the cumulative ongoing pregnancy rate was significantly higher in the long interval group (71/138; 51.4%) compared to that in the short interval group (56/142; 39.4%; relative risks 0.77; 95% CI 0.59–0.99; P = 0.044). The time to pregnancy was significantly shorter in the long interval group (log-rank test, P = 0.012). A Cox regression analysis showed similar results (adjusted hazard ratio 1.528, 95% CI 1.074–2.174, P = 0.019). LIMITATIONS, REASONS FOR CAUTION Limitations of our study are the non-blinded design, the long inclusion and follow-up period of nearly seven years and the large number of protocol violations, especially because they predominantly occurred in the short interval group. The non-significant results in the per-protocol (PP) analyses and the weaknesses of the study should be taken into account in the assessment of the borderline significance of the results in the ITT analyses. WIDER IMPLICATIONS OF THE FINDINGS Because it is not necessary to perform the IUI immediately after semen processing, there can be more time available to choose the optimum work-flow and clinic occupancy. Clinics and laboratories should find their optimal timing of insemination, considering the time between human chorionic gonadotropin injection and insemination in relation to the sperm preparation techniques used as well as the storage time and conditions until insemination. STUDY FUNDING/COMPETING INTEREST(S) There were no external funding and no competing interests to declare. TRIAL REGISTRATION NUMBER Dutch trial registry, trial registration number NTR3144. TRIAL REGISTRATION DATE 14 November 2011. DATE OF FIRST PATIENT’S ENROLLMENT 5 February 2012.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A short versus a long time interval between semen collection and intrauterine insemination: a randomized controlled clinical trial

et al. 2023

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“…The aim of COH is to obtain as many good quality oocytes as possible (2). The ideal stimulation regimen for IVF should have minimal side effects, the lowest cycle cancellation rates, the least drug cost, easy monitoring, and single pregnancy should be achieved ultimately (3). Ovarian reserve should be clearly evaluated in every woman in whom IVF is planned.…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of ovarian torsion incidence in 5186 women undergoing controlled ovarian hyperstimulation

Güngör¹,

Yurci

Güçlü

2021

Journal of Health Sciences and Medicine

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Aim: Ovarian torsion (OT) is one of the common gynecologic emergencies in reproductive age women. In our study, it is aimed to make a retrospective evaluation of OT cases developed after controlled ovarian stimulation (COH) for in vitro fertilization (IVF) treatment. Material and Method:This retrospective study was carried out in an IVF clinic between January 2015-December 2020 . Ten cases who definitely diagnosed as OT were included in this study. The medical records of these patients were examined. Data were analyzed according to demographic, clinicopathological, and sonographic findings.Results: Ten of 5186 IVF patients developed OT (10/5186; 0.19%) and all OT cases were PCOS. The mean age of OT patients was 27.3±4.1years and the mean body mass index (BMI) was 23.5±6.2 kg/m2 respectively. The mean number of retrieved oocytes was 21.46±4.12. The average diameter of the twisted ovaries of patients was 121.4±56.1 mm. Laparoscopy was performed in all OT patients for detorsion of the ovaries. It was found that OT occurred more frequently on the right side (8/10; 80%). Conclusion:OT is more common in cases with polycystic ovary syndrome (PCOS). The risk of OT is reduced by decreasing gonadotropin dosage as well as retrieved number of oocyte. Also, prefering frozen-thawed embryo transfer can decrease OT risk in PCOS patients.

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Comparing the Effectiveness of Doing Intra-uterine Insemination 36 and 42 Hours after Human Chorionic Gonadotropin (HCG) Injection on Pregnancy Rate: A Randomized Clinical Trial

Cited by 2 publications

References 25 publications

A short versus a long time interval between semen collection and intrauterine insemination: a randomized controlled clinical trial

A short versus a long time interval between semen collection and intrauterine insemination: a randomized controlled clinical trial

Retrospective analysis of ovarian torsion incidence in 5186 women undergoing controlled ovarian hyperstimulation

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