Pregnancy Predictors after Intrauterine Insemination in Cases of Unexplained Infertility: A Prospective Study

Abstract

Introduction. Aim of the study was to find the effect of various prognostic factors in cases of unexplained infertility undergoing controlled ovarian stimulation (COS) with intrauterine insemination (IUI). Methods. 146 cases of unexplained infertility were included. A maximum of 3 cycles of IUI were done with clomiphene citrate/HMG. Ovulation trigger was given when the largest follicle diameter was >18 mm, and IUI was planned 36 hours later. Luteal phase support was given for 15 days, urine pregnancy test was done on day 15, ultrasonography was done at 7 weeks, and pregnancy was followed up till delivery. Results. A total of 146 couples have undergone 239 cycles of IUI out of which 27 had UPT positive after 15 days. 14.8% had 1st-trimester abortion while 3.7% were ectopic. 86.3% were singleton pregnancies and 13.6% were twins. CPR was 11.29% per cycle and 18.4% per couple; LBR was 9.2% per cycle. Apart from duration of stimulation (p = 0.037) and number of treatment cycles (p = 0.045), no other factors had significant prognostic value. Conclusion. For unexplained infertility, IUI can be done to provide patients with the time that they need before moving on to IVF while providing a respectable chance of pregnancy.

The relationship between semen parameters in processed and unprocessed semen with IUI success rate

“…In our study, there was no significant difference regarding the mean age of the women in the (Table 2). However, the results of the present study are similar to the results of Basirat et al (11), Koyun Ok et al 14, Ganguly et al (26), and Yildirim et al (27) who failed to show a significant correlation between female age and IUI success (p=0.578). We believe that this is more likely due to the small population in our study.…”

“…The results of our study are similar to those of other studies that found no significant association between the duration of infertility and IUI success (7,8,14,20,26).…”

The efficacy of non‐assisted reproductive technology treatment might be limited in infertile patients with advanced endometriosis in their 30s

“…Our study highlighted the relationship between the benefit of non‐ART and the age‐related CLBR decline. The most important aspect of this study was that we determined the limitations of non‐ART and sought to identify optimal management methods, as non‐ART can be a more cost‐effective treatment than ART in certain circumstances and can provide patients with needed time and a respectable chance of pregnancy before moving to ART . Multivariate analysis of 10 representative infertility factors revealed that patients with a ‘Past treatment history’, ‘Uterine fibroid’ and ‘Advanced endometriosis’ had significantly lower CLBR following non‐ART (Table ).…”

“…However, ART treatment processes are invasive and expensive, and recent studies have indicated several potential risks, including adverse pregnancy and perinatal events . To avoid the unnecessary cost and risk, non‐ART infertility treatments, including mild ovarian stimulation together with timed intercourse and/or intrauterine insemination (IUI), can be effective . Ideally, clinicians should determine the most appropriate treatments for individuals; however, there are many factors that influence treatment success.…”

Two different timing of intra uterine insemination in patients of unexplained infertility: a randomized clinical trial

“…For example expectant treatment, ovarian stimulation with either clomiphene citrate (CC) or CC with gonadotropins or only gonadotropins followed by intrauterine insemination, and in vitro fertilization. 2 Ovulation stimulation without IUI is not advised lately, because an analysis of the evidence concluded that 40 cycles of ovulation induction without IUI were required to achieve one extra pregnancy. 1 The requirements for doing the procedure are: occurrence of ovulation in the IUI cycle; patent one fallopian tube at least; an adequate semen parameters for insemination; and absence of active pelvic, uterine, or cervical infection.…”