Görkem TUNCAY

The prognostic factors for pregnancy after gonadotropin-induced controlled ovarian stimulation therapy with intrauterine insemination cycles

To identify the predictive determinants for pregnancy in patients who underwent controlled ovarian stimulation (COS) /intrauterine insemination (IUI). A total 458 gonadotropin-induced controlled ovarian stimulation and intrauterine insemination cycles in 361 couples using were studied between February 2014 and January 2018. The main outcome was clinical pregnancy rate, which has been analyzed according to baseline clinical characteristics (women age, length of infertility, day 3. follicle stimulating hormone, estradiol level) and variables related to intrauterine insemination cycle (number of preovulatory follicles, endometrial thickness), and sperm parameters (sperm concentration, sperm motility, sperm morphology and total motile sperm count (TMSC). The overall clinical pregnancy rate was 11.6% (53/458) per cycle. Clinical pregnancy rate per cycle was 12.0% (43/361) in the first cycle; 10.3% (9/87) in the second cycle, and 10% (1/10) in the third cycle. Among the predictive factors evaluated, more than 25x106 TMSC was also good predictor for clinical pregnancy. The TMSC in ejaculate proved to be a useful predictor of the chance for pregnancy after IUI treatment.

PDF

___

Ombolet W, Campo R, Bosmans E, et al. Intrauterine insemination (IUI) as a first-line treatment in developing countries and methodological aspects that might influence IUI success. Hum Reprod. 2008;1:64-72.

Cantineau AE, Cohlen BJ, Heineman MJ. Ovarian stimulation protocols (anti-oetrogens, gonadotrophins with and without GnRH agonist/antagonists) for intrauterine insemination (IUI) in women with subfertility. Cochr Data System Rev. 2007;2:1469-93.

Andersen AN, Gianaroli L, Felberbaum R, et al. The European IVF- monitoring programme (EIM) for the European Society of Human Reproduction and Embryology (ESHRE), Assisted reproductive technology in Europe, 2002: results generated from European registers by ESHRE. Hum. Reprod 2006;21:1680-97.

Dorjpurev U, Kuwahara A, Yano Y, et al. Effect of semen characteristics on pregnancy rate following intrauterine insemination. J Med Invest .2011;58:127-33.

Iberico G, Vioque J, Ariza N, et al. Analysis of factors influencing pregnancy rates in homologous intrauterine insemination. Fertil Steril. 2004;81:1308-13.

Nuojua-Huttunen S, Tomas C, Bloigu R, et al. Intrauterine insemination treatment in subfertility: an analysis of factors affecting outcome. Hum Reprod. 1999;14:698-703.

Rhemrev J, Jeyendran RS, Vermeiden JPW, et al. Human sperm selection by glass wool filtration and two-layer, discontinuous Percoll gradient centrifugation. Fertil Steril. 1989;51:685-90.

World Health Organization. WHO laboratory manual for the examination and processing of human semen. 5th ed., Geneva: World Health Organization; 2010.

Paulmyer Lacroix O, Molle L, Noizet A, et al. Intrauterine insemination with the husband’s sperm: conclusions of five years experience. Contracept Fertil Sex. 1998;26:300-6.

Merviel P, Helene Heraud M, Grenier N, et al. Predictive factors for pregnancy after intrauterine insemination (IUI): An analysis of 1038 cycles and a review of the literature. Fertil Steril. 2010;93:79-88.

Tomlinson MJ, Amissah-Arthur JB, Thompson KA, et al. Prognostic indicators for intrauterine insemination (IUI): statistical model for IUI success. Hum Reprod. 1996;11:1892-6.

Nulsen JC, Walsh S, Dumez S, et al. A randomized and longitudinal study of human menopausal gonadotrophin with intrauterine insemination in the treatment of infertility. Obstet Gynecol. 1993;82:780-6.

Zadehmodarres S, Oladi B, Saeedi S, et al. Intrauterine insemination with husband semen: an evaluation of pregnancy rate and factors affecting outcome J Assist Reprod Gened. 2009;26:7-11.

Brzechffa PR, Buyalos RP. Female and male partner age and menotrophin requirements influence pregnancy rates with human menopausal gonadotrophin therapy in combination with intrauterine insemination. Hum Reprod. 1997;12:29-33.

Wainer R, Albert M, Dorion A, et al. Influence of the number of motile spermatozoa inseminated and of their morphology on the success of intrauterine insemination. Hum Reprod. 2004;19:2060-5.

Brzechffa PR, Daneshmand S, Buyalos RP. Sequential clomiphene citrate and human menopausal gonadotrophin with intrauterine insemination: the effect of patient age on clinical outcome. Hum Reprod. 1998;13:2110-4.

Bronte A, Stone PD, Ringler GE, et al. Determinants of the outcome of intrauterine insemination: analysis of outcomes of 9963 consecutives cycles. Obstet Gynecol. 1999;180:1522-64.

Van Voorhis BJ, Barnett M, Sparks AET, et al. Effect of the total motile sperm count on the efficacy and cost-effectiveness of intrauterine insemination and in vitro fertilization. Fertil Steril. 2001;75:661-8.

Dodson WC, Haney AF. Controlled ovarian hyperstimulation and intrauterine insemination for treatment of infertility. Fertil Steril. 1991;55:457-67.

Jeon YE, Jung JA, Kim HY, et al. Predictive factors for pregnancy during first four intrauterine insemination cycles using gonadotropin. Gynecol Endocrinol. 2013;29:834-8.

Coulam CB, Bustillo M, Soensksen DM, et al.Ultrasonographic predictors of implantation after assisted reproduction. Fertil Steril. 1994;62:1004-10.

Sakhel K, Schwark S, Ashraf M, et al. Semen parameters as determinants of success in 1662 cycles of intrauterine insemination after controlled hyperstimulation. Fertil Steril. 2005;84:248-9.

Belaish-Allart J, Mayenga JM, Plachot M. Intrauterine insemination Contracept Ferilt Sex. 1999;27:616-21.

Burr R, Siegberg R, Matthews C, et al. The influence of sperm morphology and the number of motile sperm inseminated on the outcome of intrauterine insemination combined with mild ovarian stimulation. Fertil Steril. 1996;65:127-32.

Karabinus DS. The impact of sperm morphology evaluated by strict criteria on intrauterine insemination success. Fertil Steril. 1997;67:536-41.

Wainer R, Albert M, Dorion A, et al. Influence of the number of motile spermatozoa inseminated and their morphology on the success of intrauterine insemination. Hum Reprod. 2004;19:2060-5.

Cohlen BJ, te Velde ER, van Kooji RJ, et al. Controlled ovarian stimulation and intrauterine insemination for treating male subfertility: acontrolled study. Hum Reprod. 1998;13:1553-8.

Miller DC, Hollenbeck BK, Smith GD, et al. Processed total motile sperm count correlates with pregnancy outcome after intra-uterine insemination. Urology. 2002;60:497-501.