Research Article
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Year 2019, Volume: 16 Issue: 4, 233 - 237, 31.12.2019

Abstract

Objective: The aim of this study was to determine the prognostic factors for pregnancy outcomes after controlled ovarian stimulation (COS)/intrauterine insemination (IUI).

Study Design: In this retrospective cohort study, a total of 202 gonadotropin-IUI cycles were analyzed between January 2017 and April 2019. Demographic features, cycle outcomes and sperm parameters were compared between pregnant (n = 44) and non-pregnant groups (n = 158). Logistic regression analysis was performed to identify factors that could predict a pregnancy.

Results: The clinical pregnancy rate was calculated as 21.8% in the whole group. Logistic regression identified four significant factors in predicting the IUI success rates; the etiology of infertility (OR:0.208; 95% CI: 0.079-0.547, P:0.001), increased TPMSC (OR:1.027; 95% CI:1.001-1.053; P:0.047), endometrial thickness (OR:1.346; 95% CI:1.120-1.617; P:0.002) and decreased duration of infertility (OR:0.951; 95% CI: 0.928-0.975, P<0.001) which were the most significant risk factors for pregnancy.

Conclusion: Among various parameters analyzed in this study, infertility etiology, infertility duration, endometrial thickness and post-washed total progressive motile sperm count found to be the most important prognostic factors in predicting successful outcome of IUI.

References

  • 1. Sicchieri F, Silva AB, Silva ACJSRE, Navarro PAAS, Ferriani RA, Reis RMD. Prognostic factors in intrauterine insemination cycles. JBRA Assist Reprod. 2018 Mar 1;22(1):2-7.
  • 2. Ghaffari F, Sadatmahalleh SJ, Akhoond MR, Eftekhari Yazdi P, Zolfaghari Z. Evaluating The Effective Factors in Pregnancy after Intrauterine Insemination: A Retrospective Study. Int J Fertil Steril. 2015 Oct-Dec;9(3):300-8.
  • 3. Dinelli L, Courbière B, Achard V, Jouve E, Deveze C, Gnisci A, et al. Prognosis factors of pregnancy after intrauterine insemination with the husband's sperm: conclusions of an analysis of 2,019 cycles. Fertil Steril. 2014;101(4):994-1000.
  • 4. Ferraretti AP, Goossens V, de Mouzon J, Bhattacharya S, Castilla JA, Korsak V, et al. Assisted reproductive technology in Europe, 2008: results generated from European registers by ESHRE. Hum Reprod. 2012 Sep;27(9):2571-84.
  • 5. Ferraretti AP, Goossens V, Kupka M, Bhattacharya S, de Mouzon J, Castilla JA, et al. Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE. Hum Reprod. 2013 Sep;28(9):2318-31.
  • 6. European IVF-Monitoring Consortium (EIM); European Society of Human Reproduction and Embryology (ESHRE), Kupka MS, D'Hooghe T, Ferraretti AP, de Mouzon J et al. Assisted reproductive technology in Europe, 2011: results generated from European registers by ESHRE. Hum Reprod. 2016 Feb;31(2):233-48.
  • 7. WHO. World Health Organization: WHO Laboratory manual for the examination and processing of human semen - 5th ed. Geneva: WHO Press 2010.
  • 8. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004 Jan;81(1):19-25.
  • 9. Merviel P, Heraud MH, Grenier N, Lourdel E, Sanguinet P, Copin H. Predictive factors for pregnancy after intrauterine insemination (IUI): an analysis of 1038 cycles and a review of the literature. Fertil Steril. 2010 Jan;93(1):79-88.
  • 10. Hansen KR, He AL, Styer AK, Wild RA, Butts S, Engmann L et al. Predictors of pregnancy and live-birth in couples with unexplained infertility after ovarian stimulation-intrauterine insemination. Fertil Steril. 2016 Jun;105(6):1575-1583 11. Ashrafi M, Rashidi M, Ghasemi A, Arabipoor A, Daghighi S, Pourasghari P,et al. The role of infertility etiology in success rate of intrauterine insemination cycles: an evaluation of predictive factors for pregnancy rate. Int J Fertil Steril. 2013 Jul;7(2):100-7
  • 12. Ganguly I, Singh A, Bhandari S, Agrawal P, Gupta N. Pregnancy Predictors after Intrauterine Insemination in Cases of Unexplained Infertility: A Prospective Study. Int J Reprod Med. 2016;2016:5817823.
  • 13. Tay PY, Raj VR, Kulenthran A, Sitizawiah O. Prognostic factors influencing pregnancy rate after stimulated intrauterine insemination. Med J Malaysia. 2007;62(4):286-9.
  • 14. Wiser A, Shalom-Paz E, Reinblatt SL, Son WY, Das M, Tulandi T, et al. Ovarian stimulation and intrauterine insemination in women aged 40 years or more. Reprod Biomed Online. 2012; 24(2): 170-173.
  • 15. Esmailzadeh S, Faramarzi M. Endometrial thickness and pregnancy outcome after intrauterine insemination. Fertil Steril. 2007 Aug;88(2):432-7
  • 16. Nikbakht, R., Saharkhiz, N. The influence of sperm morphology, total motile sperm count of semen and the number of motile sperm inseminated in sperm samples on the success of intrauterine insemination. Int J Fertil Steril. 2011 Oct;5(3):168-73.
  • 17. Kleppe M, van Hooff MH, Rhemrev JP. Effect of total motile sperm count in intra-uterine insemination on ongoing pregnancy rate. Andrologia. 2014 Dec;46(10):1183-8.
  • 18. Ombelet W, Dhont N, Thijssen A, Bosmans E, Kruger T. Semen quality and prediction of IUI success in male subfertility: a systematic review. Reprod Biomed Online. 2014 Mar;28(3):300-9.
  • 19. van Weert JM, Repping S, Van Voorhis BJ, van der Veen F, Bossuyt PM, Mol BW. Performance of the postwash total motile sperm count as a predictor of pregnancy at the time of intrauterine insemination: a meta analysis. Fertil Steril. 2004 Sep;82(3):612-20.
  • 20. Ejzenberg D, Gomes TJO, Monteleone PAA, Serafini PC, Soares-Jr JM, Baracat EC. Prognostic factors for pregnancy after intrauterine insemination. Int J Gynaecol Obstet. 2019 Jun 26.
  • 21. Erdem A, Erdem M, Atmaca S, Korucuoglu U, Karabacak O. Factors affecting live birth rate in intrauterine insemination cycles with recombinant gonadotrophin stimulation. Reprod Biomed Online. 2008;17:199-206.
  • 22. Thijssen A, Creemers A, Van der Elst W, Creemers E, Vandormael E, Dhont N, Ombelet W. Predictive value of different covariates influencing pregnancy rate following intrauterine insemination with homologous semen: a prospective cohort study. Reprod Biomed Online. 2017 May;34(5):463-472.
  • 23. Mullin C, Virji N, Saketos M. San Roman G. Day 2 follicles stimulating hormone (FSH) and estradiol (E2): could these values be used as markers to predict pregnancy outcomes in women undergoing ovulation induction (OI) therapy with intrauterine insemination (IUI) cycles? Fertil Steril 2005; 84(Suppl):S162.
  • 24. Soria M, Pradillo G, García J, Ram_on P, Castillo A, Jordana C, et al. Pregnancy predictors after intrauterine insemination: analysis of 3012 cycles in 1201 couples. J Reprod Infertil. 2012 Jul;13(3):158-66.
  • 25. Michau A, El Hachem H, Galey J, Le Parco S, Perdigao S, Guthauser B. Predictive factors for pregnancy after controlled ovarian stimulation and intrauterine insemination: A retrospective analysis of 4146 cycles. J Gynecol Obstet Hum Reprod. 2019 May 3.
  • 26. Wu HM, Tzeng CR, Chen CH, Chen PH. Pelvic endometriosis with peritoneal fluid reduces pregnancy rates in women undergoing intrauterine insemination. Taiwan J Obstet Gynecol. 2013 Dec;52(4):512-5.

Prognostic Factors Influencing Pregnancy Rates in Intrauterine Insemination Cycles

Year 2019, Volume: 16 Issue: 4, 233 - 237, 31.12.2019

Abstract

Amaç: Bu çalışmada Kontrollü Ovarian Stimulasyon (KOH)/Intrauterin Inseminasyon (IUI) sonrası gebelik sonuçlarını etkileyen prognostik faktörlerin belirlenmesi amaçlanmıştır.

Gereç ve Yöntemler: Bu retrospektif kohort çalışmasında, Ocak 2017 ve Nisan 2019 tarihleri arasında toplam 202 gonadotropin-IUI siklusu analiz edildi. Gebelik saptanan (n = 44) ve saptanmayan (n = 158) iki grup, demografik özellikler, siklus sonuçları ve sperm parametreleri açısından karşılaştırıldı. Gebeliği etkileyebilecek faktörleri belirlemek için lojistik regresyon analizi yapıldı.

Bulgular: Klinik gebelik oranı tüm grupta % 21.8 olarak hesaplandı. Lojistik regresyon, IUI başarı oranlarını öngörmede dört önemli faktör tanımladı; infertilite etiyolojisi (OR: 0.208;% 95 CI: 0.079-0.547, P: 0.001), artmış total progresif motil sperm sayısı (TPMSS) (OR: 1.027;% 95 CI: 1.001-1.053; P: 0.047), endometrial kalınlık (OR: 1.346; 95 % CI: 1.120-1.617; P: 0.002) ve azalmış infertilite süresi (OR: 0.951;% 95 CI: 0.928-0.975, P <0.001), gebelik için en önemli risk faktörleriydi.

Sonuç: Bu çalışmada analiz edilen çeşitli parametrelerden infertilite etiyolojisi, infertilite süresi, endometrial kalınlık ve yıkama sonrası progressive motil sperm sayısı,intrauterin inseminasyonun başarısını etkileyen en önemli prognostik faktörlerdir

References

  • 1. Sicchieri F, Silva AB, Silva ACJSRE, Navarro PAAS, Ferriani RA, Reis RMD. Prognostic factors in intrauterine insemination cycles. JBRA Assist Reprod. 2018 Mar 1;22(1):2-7.
  • 2. Ghaffari F, Sadatmahalleh SJ, Akhoond MR, Eftekhari Yazdi P, Zolfaghari Z. Evaluating The Effective Factors in Pregnancy after Intrauterine Insemination: A Retrospective Study. Int J Fertil Steril. 2015 Oct-Dec;9(3):300-8.
  • 3. Dinelli L, Courbière B, Achard V, Jouve E, Deveze C, Gnisci A, et al. Prognosis factors of pregnancy after intrauterine insemination with the husband's sperm: conclusions of an analysis of 2,019 cycles. Fertil Steril. 2014;101(4):994-1000.
  • 4. Ferraretti AP, Goossens V, de Mouzon J, Bhattacharya S, Castilla JA, Korsak V, et al. Assisted reproductive technology in Europe, 2008: results generated from European registers by ESHRE. Hum Reprod. 2012 Sep;27(9):2571-84.
  • 5. Ferraretti AP, Goossens V, Kupka M, Bhattacharya S, de Mouzon J, Castilla JA, et al. Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE. Hum Reprod. 2013 Sep;28(9):2318-31.
  • 6. European IVF-Monitoring Consortium (EIM); European Society of Human Reproduction and Embryology (ESHRE), Kupka MS, D'Hooghe T, Ferraretti AP, de Mouzon J et al. Assisted reproductive technology in Europe, 2011: results generated from European registers by ESHRE. Hum Reprod. 2016 Feb;31(2):233-48.
  • 7. WHO. World Health Organization: WHO Laboratory manual for the examination and processing of human semen - 5th ed. Geneva: WHO Press 2010.
  • 8. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004 Jan;81(1):19-25.
  • 9. Merviel P, Heraud MH, Grenier N, Lourdel E, Sanguinet P, Copin H. Predictive factors for pregnancy after intrauterine insemination (IUI): an analysis of 1038 cycles and a review of the literature. Fertil Steril. 2010 Jan;93(1):79-88.
  • 10. Hansen KR, He AL, Styer AK, Wild RA, Butts S, Engmann L et al. Predictors of pregnancy and live-birth in couples with unexplained infertility after ovarian stimulation-intrauterine insemination. Fertil Steril. 2016 Jun;105(6):1575-1583 11. Ashrafi M, Rashidi M, Ghasemi A, Arabipoor A, Daghighi S, Pourasghari P,et al. The role of infertility etiology in success rate of intrauterine insemination cycles: an evaluation of predictive factors for pregnancy rate. Int J Fertil Steril. 2013 Jul;7(2):100-7
  • 12. Ganguly I, Singh A, Bhandari S, Agrawal P, Gupta N. Pregnancy Predictors after Intrauterine Insemination in Cases of Unexplained Infertility: A Prospective Study. Int J Reprod Med. 2016;2016:5817823.
  • 13. Tay PY, Raj VR, Kulenthran A, Sitizawiah O. Prognostic factors influencing pregnancy rate after stimulated intrauterine insemination. Med J Malaysia. 2007;62(4):286-9.
  • 14. Wiser A, Shalom-Paz E, Reinblatt SL, Son WY, Das M, Tulandi T, et al. Ovarian stimulation and intrauterine insemination in women aged 40 years or more. Reprod Biomed Online. 2012; 24(2): 170-173.
  • 15. Esmailzadeh S, Faramarzi M. Endometrial thickness and pregnancy outcome after intrauterine insemination. Fertil Steril. 2007 Aug;88(2):432-7
  • 16. Nikbakht, R., Saharkhiz, N. The influence of sperm morphology, total motile sperm count of semen and the number of motile sperm inseminated in sperm samples on the success of intrauterine insemination. Int J Fertil Steril. 2011 Oct;5(3):168-73.
  • 17. Kleppe M, van Hooff MH, Rhemrev JP. Effect of total motile sperm count in intra-uterine insemination on ongoing pregnancy rate. Andrologia. 2014 Dec;46(10):1183-8.
  • 18. Ombelet W, Dhont N, Thijssen A, Bosmans E, Kruger T. Semen quality and prediction of IUI success in male subfertility: a systematic review. Reprod Biomed Online. 2014 Mar;28(3):300-9.
  • 19. van Weert JM, Repping S, Van Voorhis BJ, van der Veen F, Bossuyt PM, Mol BW. Performance of the postwash total motile sperm count as a predictor of pregnancy at the time of intrauterine insemination: a meta analysis. Fertil Steril. 2004 Sep;82(3):612-20.
  • 20. Ejzenberg D, Gomes TJO, Monteleone PAA, Serafini PC, Soares-Jr JM, Baracat EC. Prognostic factors for pregnancy after intrauterine insemination. Int J Gynaecol Obstet. 2019 Jun 26.
  • 21. Erdem A, Erdem M, Atmaca S, Korucuoglu U, Karabacak O. Factors affecting live birth rate in intrauterine insemination cycles with recombinant gonadotrophin stimulation. Reprod Biomed Online. 2008;17:199-206.
  • 22. Thijssen A, Creemers A, Van der Elst W, Creemers E, Vandormael E, Dhont N, Ombelet W. Predictive value of different covariates influencing pregnancy rate following intrauterine insemination with homologous semen: a prospective cohort study. Reprod Biomed Online. 2017 May;34(5):463-472.
  • 23. Mullin C, Virji N, Saketos M. San Roman G. Day 2 follicles stimulating hormone (FSH) and estradiol (E2): could these values be used as markers to predict pregnancy outcomes in women undergoing ovulation induction (OI) therapy with intrauterine insemination (IUI) cycles? Fertil Steril 2005; 84(Suppl):S162.
  • 24. Soria M, Pradillo G, García J, Ram_on P, Castillo A, Jordana C, et al. Pregnancy predictors after intrauterine insemination: analysis of 3012 cycles in 1201 couples. J Reprod Infertil. 2012 Jul;13(3):158-66.
  • 25. Michau A, El Hachem H, Galey J, Le Parco S, Perdigao S, Guthauser B. Predictive factors for pregnancy after controlled ovarian stimulation and intrauterine insemination: A retrospective analysis of 4146 cycles. J Gynecol Obstet Hum Reprod. 2019 May 3.
  • 26. Wu HM, Tzeng CR, Chen CH, Chen PH. Pelvic endometriosis with peritoneal fluid reduces pregnancy rates in women undergoing intrauterine insemination. Taiwan J Obstet Gynecol. 2013 Dec;52(4):512-5.
There are 25 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Articles
Authors

Ömer Hamid Yumuşak 0000-0002-6632-5890

Aytekin Tokmak 0000-0001-5739-5689

Berna Seckin 0000-0003-3294-237X

Publication Date December 31, 2019
Submission Date December 27, 2019
Acceptance Date December 29, 2019
Published in Issue Year 2019 Volume: 16 Issue: 4

Cite

Vancouver Yumuşak ÖH, Tokmak A, Seckin B. Prognostic Factors Influencing Pregnancy Rates in Intrauterine Insemination Cycles. JGON. 2019;16(4):233-7.