A comparative analysis of arterial blood flow in unexplained infertility, tubal infertility and fertile groups.

We aimed to compare ovarian (O), uterine (U) and spiral (S) artery (A) resistance of patients diagnosed as fertile, unexplained infertility (UI) and tubal factor infertility (TFI) in the peri-implantation period and independent from the impact of the treatment. UI (n = 70), TFI (n = 75) and fertile (n = 72) patients' ovarian, uterine and spiral artery pulsatility index (PI), resistance index (RI) and the endometrial thickness, serum estradiol and progesterone levels were compared. The specificity and sensitivity values were calculated according to determined cutoff values. Both TFI and control groups' UA PI values were significantly lower than the UI group's PI values. The highest UA RI values were found in UI group and the lowest values were in the control group. UI and TFI groups' OA PI/RI values were significantly higher than the control group. Both the control and TFI groups' SA PI/RI values were significantly lower than UI group's PI/RI values. UI patients' uterine and spiral arteries PI values >1.86 and >0.85, RI values >0.80 and >0.53 can be used as a valuable test showing reduced uterine perfusion. Ovarian artery PI values >0.96 and RI values >0.58 can be used as tests showing decreased ovarian perfusion in patients with TFI. In these patients, embryo cryopreservation can be considered.

Evaluation of ten years of intrauterine insemination results at a tertiary center.

PURPOSE: To report on ten years of intrauterine insemination (IUI) practice at Haseki Training and Research Hospital to determine retrospectively, the impact of IUI on the management of subfertile couples. MATERIALS AND METHODS: This study was a retrospective analsis of all IUI cycles completed from June 1, 2003, to July 1, 2013, at the Haseki Training and Research Hospital, Istanbul, Turkey. Baseline clinical characteristics, drugs used for ovulation induction, and triggering ovulation were reviewed. The primary outcome was clinical pregnancy. RESULTS: The overall clinical pregnancy rate was 10.2% (26/253). Improved success was significantly associated with a shorter period of infertility (4.8 ± 3.9 years vs 3.2±2.4 years; p = 0.01). Clinical pregnancy rates were significantly higher when recombinant FSH was used for ovulation induction than clomiphene citrate (CC) (22% vs 5.6%; p = 0.002). Patients were also analysed for the drug used for triggering ovulation. The clinical pregnancy rate was 27.2% in the recombinant hCG group compared with 8.6% in the urinary hCG group (p = 0.006). CONCLUSIONS: IUI may be a safe and cost-effective option for mild male factor infertility or un- explained infertility. Better results may be obtained when recombinant FSH and recombinant hCG are used and when the duration of infertility is short.