Dinelli L, Courbière B, Achard V, Jouve E, Deveze C, Gnisci A, Grillo JM, Paulmyer-Lacroix O. Prognosis factors of pregnancy after intrauterine insemination with the husband's sperm: conclusions of an analysis of 2,019 cycles.
Fertil Steril 2014;
101:994-1000. [PMID:
24534285 DOI:
10.1016/j.fertnstert.2014.01.009]
[Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 01/06/2014] [Accepted: 01/06/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE
To identify the prognostic factors for pregnancy after intrauterine insemination with the husband's sperm (IUI-H).
DESIGN
Retrospective study.
SETTING
A single university medical center.
PATIENT(S)
851 couples, for 2,019 IUI-H cycles.
INTERVENTION(S)
After controlled ovarian stimulation, IUI-H performed 36 hours after ovulation triggering or 24 hours after a spontaneous luteinizing hormone (LH) surge.
MAIN OUTCOME MEASURE(S)
Clinical pregnancy rate per cycle (PR) and delivery rate per cycle (DR).
RESULT(S)
The overall PR was 14.8% and DR 10.8%. Higher PR and DR were observed for patients presenting with ovulation disorders (particularly polycystic ovary syndrome) or with male infertility. Secondary infertility in the woman appeared to be a positive prognostic factor as did a basal follicle-stimulating hormone (FSH) level ≤ 7 IU/L and ovulation triggering over spontaneous LH rise. The other parameters influencing the results were the women's age, the number of mature follicles obtained (≥ 2), the endometrial thickness (10-11 mm), and the number of progressive motile spermatozoa inseminated (>1 million).
CONCLUSION(S)
In women aged ≤ 38 years, IUI-H should be considered as an option, particularly in cases of female infertility from ovulation disorders, in cases of a normal ovarian reserve, in cases of secondary infertility, or when ≥ 1 million progressive sperm are inseminated. Bifollicular stimulation is required. In other cases, in vitro fertilization should be discussed as the first-line treatment.
Collapse