Samettin ÇELİK, Banuhan ŞAHİN, Aysemin GÜRÇAĞLAR, Canan SOYER ÇALIŞKAN, Şafak HATIRNAZ

HCG uygulamasından 36 saat ile 42 saat sonra yapılan intrauterin inseminasyonların klinik sonuçlarının karşılaştırılması

Amaç: İntrauterin inseminasyon (IUI), infertil çiftlerin gebelik şansını artırmak için yaygın olarak kullanılan bir işlemdir. hCG (human koryonik gonadotropin) uygulaması sonrası planlanan IUI zamanlaması pratikte 36. Saat olarak belirlenmiştir. Ancak klinik yoğunluk sebebi ile bu zamanlamada gecikmeler yaşanabilmektedir. Biz de çalışmamızda IUI’ları 36. Saate ve 42. Saate yapılan hastaların klinik sonuçlarını karşılaştırmayı amaçladık.Yöntem: Samsun Eğitim ve Araştırma Hastanesine açıklanamayan infertilite sebebi ile başvurmuş ve gonadotropin tedavisi sonrası IUI yapılmış 450 hastanın kayıtları geriye dönük incelendi. Klinikteki yoğunluk sebebi ile hCG uygulaması sonrası IUI zamanlaması 6 saat gecikmiş (42. Saat) olan hastalar ile zamanında (36. Saat) yapılmış hastaların demografik bilgileri, hormon düzeyleri, endometrium kalınlıkları, toplam folikül sayıları, β-hCG test pozitiflikleri, canlı doğum oranları ve spontan abort oranları değerlendirildi. Gruplar arası karşılaştırmalarda Student t test ve Ki-kare testi uygulandı.Bulgular: Hastaların 348’ine IUI prosedürü hCG uygulaması sonrasında 36. Saatte uygulanmışken 102’sine 42. Saatte uygulanmıştı. Gruplar arasında yaş, infertilite süresi, bazal hormon düzeyleri ve endometrial kalınlıklar açısından fark izlenmedi (p <0.05) (Tablo 1). IUI tedavilerinin gebelik sonuçları üzerine olan etkileri incelendiğinde gruplar arasında ovulasyon indüksiyonu sonrası elde edilen dominant folikül sayıları, β-hCG test pozitiflikleri, canlı doğum oranları ve spontan abortus oranları açısından fark görülmedi (p=0.34, p=0.12, p=0.31, p=0.25) (Tablo 2). Sonuç: hCG enjeksiyonu ile tetiklenen ovulasyonun ardından IUI zamanlaması 42. saate geciktirilen hastaların klinik gebelik oranları 36. Saatte IUI yapılanlara göre değişmemektedir.

Anahtar Kelimeler:

infertilite, intrauterin inseminasyon, canlı doğum

Comparison of clinical outcomes of intrauterine inseminations which performed at 36 hours versus 42 hours after hCG trigger

Aim: Intrauterine insemination (IUI) is a commonly used procedure to increase the chance of pregnancy in infertile couples. The planned IUI timing after hCG (human chorionic gonadotropin) trigger was practically determined as at 36th hour. However, this timing may be delayed due to clinical traffic. In our study, we aimed to compare the clinical results of patients who underwent IUIs at 36th hour versus at 42nd hour.Method: The records of 450 patients who were admitted to Samsun Training and Research Hospital due to unexplained infertility and were performed IUI after gonadotropin treatment, were retrospectively analyzed. Demographic information, hormone levels, endometrial thickness, total follicle numbers, β-hCG test positivity, live birth rates, and spontaneous abortion rates of patients with 6 hours delay (42 hours) in IUI timing after hCG trigger due to the traffic in the clinic, and patients with on the time (36 hours) IUI performation were evaluated. Student's t-test and Chi-square test were used for comparisons between groups.Results: IUI procedures were applied to 348 patients at the 36th hour and 102 patients at the 42nd hour after the hCG triggers. No difference was observed between the groups in terms of ages, infertility durations, basal hormone levels and endometrial thicknesses (p <0.05) (Table 1). When the effects of IUI treatments on pregnancy outcomes were examined, there was no difference between groups in terms of dominant follicle numbers obtained after ovulation induction, β-hCG test positivity, livebirth rates and spontaneous abortion rates. (p=0.34, p=0.12, p=0.31, p=0.25) (Table 2). Conclusion: The clinical pregnancy rates of patients with IUI timing after ovulation induced by hCG injection does not change with delaying to 42nd hour versus 36th hour.

Keywords:

infertility, intrauterine insemination, livebirth,

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