Prognosis factors of pregnancy after intrauterine insemination with the husbands sperm Conclusions of an analysis of 2019 cycles

Capsule:
Positive predictive factors of pregnancy after IUI-H were woman’s secondary infertility, woman basal FSH levels 7 IU/L, ovulation triggering and inseminated progressive motile spermatozoa 1 million.

Authors:
Laka Dinelli, M.D., Blandine Courbiere, M.D., Ph.D., Vincent Achard, M.D., Ph.D., Elisabeth Jouve, M.Sc., Carole Deveze, M.D., Audrey Gnisci, M.D., Jean-Marie Grillo, M.D., Ph.D., Odile Paulmyer-Lacroix, M.D., Ph.D.

Volume 101, Issue 4, Pages 994-1000

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.

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