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

Ömer Hamid Yumuşak , Aytekin Tokmak , Berna Seckin

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.

Keywords

intrauterine insemination prognostic factors infertility pregnancy rate

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

Ömer Hamid Yumuşak , Aytekin Tokmak , Berna Seckin

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

Keywords

intrauterin inseminasyon prognostik faktörler infertilite gebelik oranı

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.
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