Younger women with ovulation disorders and unexplained infertility predict a higher success rate in superovulation (SO) intrauterine insemination (IUI)
Annals of the Academy of Medicine, Singapore
; : 225-231, 2014.
Article
in En
| WPRIM
| ID: wpr-285519
Responsible library:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>Superovulation-intrauterine insemination (SO-IUI) is the most common assisted reproductive technique (ART) in the world, with good evidence of efficacy and cost-effectiveness. However, parameters affecting its success have not been consistently reported. So in this study, we aim at determining the parameters influencing the success rate of SO-IUI.</p><p><b>MATERIALS AND METHODS</b>We conducted a retrospective cohort study of 797 SO-IUI cycles from 606 patients, performed between 2007 and 2009 in a single centre. These women received clomiphene citrate (CC), recombinant FSH (rFSH) or both.</p><p><b>RESULTS</b>There were 127 clinical pregnancies with a pregnancy rate (PR) of 15.9% (127/797) per treatment cycle. Factors associated with higher PR included maternal age <38 (P = 0.02), subfertility diagnoses of ovulatory disorders, unexplained infertility, sexual dysfunction and unilateral tubal obstruction (P = 0.02), an endometrial thickness ≥8 mm (P = 0.03), total number motile spermatozoa (TNMS) of ≥1 million (P = 0.03), and spermatozoa normal forms (NF) ≥4% (P <0.01) on bivariate analysis. When CC is used, the endometrial thickness is more likely to be suboptimal (<8 mm). All the above parameters remained significant except the subfertility diagnoses on multivariate analysis.</p><p><b>CONCLUSION</b>Patients' selection with women <38 years old and preferably with ovulation disorders and unexplained infertility is associated with the highest PR in SO-IUI. Cycle parameters such as the use of rFSH alone, with the avoidance of CC, TNMS ≥1 million and NF ≥4% is likely to result in the best outcomes and reduce the high order multiple pregnancy risk.</p>
Full text:
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Index:
WPRIM
Main subject:
Prognosis
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Superovulation
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Insemination, Artificial
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Retrospective Studies
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Cohort Studies
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Age Factors
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Clomiphene
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Pregnancy Rate
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Therapeutic Uses
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Fertility Agents, Female
Type of study:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limits:
Adult
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Female
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Humans
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Pregnancy
Language:
En
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2014
Type:
Article