Synchronised approach for intrauterine insemination in subfertile couples

Cantineau, Astrid E. P.; Janssen, Mirjam J; Cohlen, Ben J; Allersma, Thomas

doi:10.1002/14651858.cd006942.pub3

Cited by 50 publications

(46 citation statements)

References 55 publications

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“…The risk of multiple pregnancies after stimulation of two, three and four follicles is estimated to increase by 6, 14 and 10 % [32]. The contribution made by IUI to the number of multiple pregnancies in the Netherlands was much smaller than the contribution made by IVF [33,34]. Simply shifting IUI from unifollicular to bifollicular IUI cycles will potentially increase the chance of achieving an IUI pregnancy by 3.4-fold [6] and, along with crucial monitoring to minimise higher-order births, IUI can become an even stronger basis for first-line treatment.…”

Section: Discussionmentioning

confidence: 92%

“…There was insufficient evidence to determine whether there is any difference in safety and effectiveness between different methods of synchronisation and timing of ovulation and insemination [33,34]. For our pregnant cohort, the timing of insemination was recorded as 29.7 h (mean, 2.5-38.4 h) prior to hCG trigger taking account of the restricted alternate day IUI service, and it is rather surprising that few studies were designed to find the optimal time for insemination [35].…”

Section: Discussionmentioning

confidence: 99%

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Factors Leading to Pregnancies in Stimulated Intrauterine Insemination Cycles and the Use of Consecutive Ejaculations Within a Small Clinic Environment

Bahadur

Almossawi

IIlahibuccus

et al. 2016

J Obstet Gynecol India

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Introduction Understanding and improving IUI pregnancy rates has enormous global appeal and application. This pilot study goes one step further by utilising consecutive ejaculates from men with oligozoospermia and comparing with normozoospermic male group. Materials and Methods A retrospective analysis was performed on 117 IUI-stimulated treatment cycles in a small fertility clinic in North Middlesex University Hospitals Trust, UK, within a NHS setting. Risks of OHSS and multiple births are carefully controlled. Results In our cohort, several factors are associated with positive IUI pregnancies and these were: age of the woman, inseminating with C5 total progressive motile sperm; having C50 % Grade A sperm progression and having C1 Dr. Gulam Bahadur is a past member of the HFEA. His main involvement is in andrology with special emphasis on diagnostic analyses, male cancer patients, counselling, sperm donor recruitment and sperm freezing, and recovery rates following cryopreservation. Important ways to optimise pregnancy rates in simple first-line treatment intrauterine insemination are being researched and applied within a number of UK NHS Trust Hospitals. Dr Bahadur has made significant contributions to the understanding of semen qualities in subfertile males, cancer patients, adolescent cancer patients and produced one of the first reports on ovarian tissue freezing for cancer patients.The Journal of Obstetrics and Gynecology of India (September-October 2016) 66(S1):S513-S520 DOI 10.1007/s13224-016-0876-0 123follicle achieved with a realistic hMG dosage, hCG trigger and IUI of 29.7 h (2.5-38.4 h), with an endometrial thickness of 10.7 mm (6.6-13.4 mm). Bifollicular presence in at least half the cases along with hMG protocols added usefully to the pregnancy outcomes. Conclusions The pregnancy rates per cycle were 19 and 23 % in the consecutive ejaculates and non-consecutive ejaculate groups, respectively, P = 0.59. For the whole cohort, the pregnancy rate was 20.51 % per cycle and 33.8 % per women. This approach if validated with large RCT will have universally beneficial effects.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Factors Leading to Pregnancies in Stimulated Intrauterine Insemination Cycles and the Use of Consecutive Ejaculations Within a Small Clinic Environment

Bahadur

Almossawi

IIlahibuccus

et al. 2016

J Obstet Gynecol India

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“…4 Moreover, the Cochrane review provided no evidence of a difference in pregnancy rates based upon varying IUI timing ranging from 24 to 48 hours after hCG injection and stated that there is insufficient evidence to determine whether there is any difference in effectiveness between different synchronized approaches for IUI in sub fertile couples. 2 Kucuk performed IUI 36-38 hours following hCG and stated in his study that more than timing, documentation of ovulation improves the success of IUI. In the women where ovulation was evident, clinical pregnancy rate was 23.5% as compared to only 8.1% when follicle rupture was not seen (p<0.001).…”

Section: Discussionmentioning

confidence: 99%

“…2 However conflicting reports in literature regarding the ideal time interval between ovulation trigger and IUI continue to confuse. 3,4 It is postulated that prolonged time interval between sperm preparation and IUI may exhaust energy sources in processed semen thereby affecting the sperm ability to fertilize ova.…”

mentioning

confidence: 99%

Decoding the effect of time interval between hCG and IUI and sperm preparation and IUI

Agrawal

Das

Karuna

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONIntrauterine Insemination (IUI) along with controlled ovarian stimulation has been a widely used method in management of women with infertility. IUI remains a relatively inexpensive, less invasive and easy to perform procedure, which if timed well can give favorable results. It is used in male factor infertility, minimal to mild endometriosis, PCOS, cervical factor or unexplained infertility. IUI has various determinants of success. Of these, sperm morphology, method of sperm preparation, cause of infertility, ovulation induction regime used, agent for ovulation trigger, etc. are important. Along with these, time interval between ovulation induction and IUI and time interval between sperm preparation and IUI are of definite clinical relevance.The timing of IUI, in the majority of published studies, is 32-36 h following hCG administration (used for ovulation trigger).1 Cochrane review compared the different time intervals from hCG trigger to IUI ranging from 24 to 48 hours and found that there is no difference ABSTRACT Background: The study was aimed to assess the difference in IUI outcome depending on the interval between hCG trigger and IUI and sperm preparation and IUI. Methods: The study was conducted in the Department of Obstetrics and Gynecology in Infertility unit at King George's Medical University, Lucknow from January-December 2016. All the women eligible for IUI were included in the study. Once the follicle attained size of 17-18 mm, IUI was planned 36-48 hours after Inj. hCG 10,000 IU im. Semen processing was done in laboratory and time noted between sperm preparation and IUI. Outcome was confirmation of pregnancy by urine test. Cases were women in whom IUI was done 36-40 hours after hCG as against controls (>40 hours). Interval between sperm preparation and IUI was <30 minutes in cases and ≥30 minutes in controls. Results: A total of 624 cycles were included in the study. Clomiphene was used in 582/624 cycles (93.3%) gonadotropins used in 42/624 cycles (2.7%). There was a total of 23 conceptions in study (3.7%). Of these 8/98 (8.2%) were seen when the interval between ovulation trigger and IUI was 36-40 hours and 15/526 in cycles (2.9%) when the interval was more than 40 hours (p=0.023; OR-3.028 95% CI -1.247-7.352). Of a total of 23 conceptions in the study, 18/324 conceptions were seen when IUI was done within 30 minutes of sperm preparation as compared to 5/300 when interval was more than 30 minutes (p=0.01). Conclusions: IUI with ovarian stimulation is a simple and effective procedure and its outcome can be maximized keeping in consideration the availability of gametes. IUI performed within 36-40 hours of hCG trigger and within 30 minutes of sperm preparation can increase conception rates.

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“…Cantineu ve ark.nın konuyla ilgili yaptıkları Cochrane metaanalizinde hCG ile IUI intervali açısından ele alınan iki randomize kontrollü çalışmada sonuçlar açısından fark olmadığı ancak çalışma sayısının yetersiz olduğu ve konuyla ilgili daha fazla çalışmaya gereksinim olduğu bildirilmiştir. 34 IUI sikluslarında luteal faz desteği ile ilgili çeşitli görüşler bulunmakta ancak mild stimülasyon yapıldığında (1-2 folikül gelişimi) luteal fazda hCG veya progesteron eklenmesinin gebelik oranlarını artıracağı ile ilgili bir kanıt bulunmadığı öne sürülmüştür. 32 Ancak etkinliği ile ilgili bir kanıt olmamakla birlikte luteal fazda progesteron veya hCG eklemenin günlük pratikte sık uygulanan bir yaklaşım olduğu da bildirilmiştir.…”

Section: Gonadotropi̇nlerunclassified

Ovulation Induction in Intrauterine Insemination Cycles

Şahin¹,

Göker²,

Akdoğan³

et al. 2017

TJRMS

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36ntrauterin inseminasyon (IUI); günümüzde koital problemleri olan çiftler, servikal faktör, şiddetli olmayan erkek faktörlü infertilite, oligoanovulasyon, nedeni açıklanamayan infertilite, hafif endometriozis varlığı gibi çok geniş endikasyon yelpazesinde klinik pratikte uygulanmakta olan bir metoddur. Ancak dünyada IUI endikasyonları ile ilgili önerilerde farklılıklar bulunmaktadır. Etkinliği konusundaki tartışmalara rağmen IUI, seçilmiş çiftlerde infertilite tedavisinde sıklıkla uygulanan bir yöntemdir. IUI başarısı birçok faktöre bağlıdır. Gebelik oranlarında artış sağlamak için sıklıkla ovaryan stimülasyonla kombine edilmektedir. Değişik ovulasyon indüksiyon ajanları bu amaçla kullanılabilinir. Bu yaklaşımın mantığı, bazı hafif ovulatuar problemlerin düzeltilmesi, fertilizasyon şansının artırılması ve IUI zamanlamasının doğru yapılmasıdır. Ovulasyon indüksiyonuna gereksinim olduğunda, çoğul gebelik ve ovaryan hiperstimülasyon sendromundan kaçınmak için minimal stimülasyon rejimleri kullanılmalıdır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : IUI (intrauterin inseminasyon); ovulasyon indüksiyonu; çoğul gebelikler; OHSS A AB BS S T TR RA AC CT TDespite the controversies on its effectiveness, intrauterine insemination (IUI) is a commonly used procedure for infertility treatment for selected couples. IUI success depends on various factors. To improve the pregnancy rates, IUI is often combined with ovarian stimulation. Different ovulation induction agents can be used for this purpose. The rationality of this approach is correction of some subtle ovulatuar problems, enhancing the fertilization chance and proper timing of IUI. In case of a need for ovulation induction, minimal stimulation regimens should be used to avoid multiple pregnancies and ovarian hyperstimulation syndrome.

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Synchronised approach for intrauterine insemination in subfertile couples

Abstract: There is insufficient evidence to determine whether there is any difference in safety and effectiveness between different methods of synchronization of ovulation and insemination. More research is needed.

Cited by 50 publications

References 55 publications

Factors Leading to Pregnancies in Stimulated Intrauterine Insemination Cycles and the Use of Consecutive Ejaculations Within a Small Clinic Environment

Factors Leading to Pregnancies in Stimulated Intrauterine Insemination Cycles and the Use of Consecutive Ejaculations Within a Small Clinic Environment

Decoding the effect of time interval between hCG and IUI and sperm preparation and IUI

Ovulation Induction in Intrauterine Insemination Cycles

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