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

Year 2019, Volume: 50 Issue: 3, 108 - 111, 15.09.2019
https://doi.org/10.16948/zktipb.566761

Abstract

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. 

Supporting Institution

Samsun Eğitim ve Araştırma Hastanesi

Project Number

37-2019BADK/8-69

References

  • Referanslar:1. Dodson WC, Haney AF. Controlled ovarian hyperstimulation and intrauterine insemination for treatment of infertility. Fertil Steril 1991; 55: 457–467.2. Duran H, Mahmood M, Kruger T, Oehninger S. Intrauterine insemination: a systematic review on determinants of success. Hum Reprod Update 2002; 8: 373–384.3. ESHRE Capri Workshop Group. Intrauterine insemination. Hum Reprod Update 2009; 15: 265e77.4. Ragni G, Somigliana E, Vegetti W. Timing of intrauterine insemination: Where are we? Fertil Steril 2004; 82: 25–26.5. Cohlen BJ, te Velde ER, van Kooij RJ, Looman CW, Habbema JD. Controlled ovarian hyperstimulation and intrauterine insemination for treating male subfertility: A controlled study. Hum Reprod 1998; 13: 1553–1558.6. Jarvela IY, Tapanainen JS, Martikainen H. Improved pregnancy rate with administration of hCG after intrauterine insemination: A pilot study. Reprod Biol Endocrinol 2010; 8: 18.7. Aydin Y, Hassa H, Oge T, Tokgoz VY. A randomized study of simultaneous hCG administration with intrauterine insemination in stimulated cycles. Eur J Obstet Gynecol Reprod Biol 2013; 170: 444–448.8. Tonguc E, Var T, Onalan G, Altinbas S, Tokmak A, Karakaş N, Gulerman C. Comparison of the effectiveness of single versus double intrauterine insemination with three different timing regimens. Fertil Steril. 2010; 94: 1267-1270.9. Cooper TG, Noonan E, von Eckardstein S. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010; 16: 231–245.10. 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; 93: 79–88.11. Demir B, Dilbaz B, Cinar O, Karadag B, Tasci Y, Kocak M, Dilbaz S, Goktolga U. Factors affecting pregnancy outcome of intrauterine insemination cycles in couples with favourable female characteristics. J Obstet Gynaecol 2011; 31: 420–423.12. World Health Organization, Task Force on Methods for the Determination of the Fertile Period, Special Programme of Research, Development and Research Training in Human Reproduction. Temporal relationships between ovulation and defined changes in the concentration of plasma estradiol-17 beta, luteinizing hormone, follicle-stimulating hormone, and progesterone. I. Probit analysis. Am J Obstet Gynecol 1980; 138: 383–390.13. Ghanem ME, Bakre NI, Emam MA, Al Boghdady LA, Helal AS, Elmetwally AG, Hassan M, Albahlol IA, Elzayat MM. The effects of timing of intrauterine insemination in relation to ovulation and the number of inseminations on cycle pregnancy rate in common infertility etiologies. Hum Reprod 2011; 26: 576–583.14. Lee J, Hwang S, Lee J, Yoo J, Jang D, Hwang K, Kim M. Effect of insemination timing on pregnancy outcome in association with female age, sperm motility, sperm morphology and sperm concentration in intrauterine insemination. J Obstet Gynaecol Res. 2018; 44: 1100-1106. 15. Lemmens L, Kos S, Beijer C, Brinkman JW, van der Horst FA, van den Hoven L, Kieslinger DC. Predictive value of sperm morphology and progressively motile sperm count for pregnancy outcomes in intrauterine insemination. Fertil Steril 2016; 105: 1462–1468.16. Yumusak OH, Kahyaoglu S, Pekcan MK, Isci E, Cinar M, Tasci Y. Does intrauterine insemination timing matter for achieving pregnancy during ovulation induction using gonadotropins? A retrospective cohort study. J Chin Med Assoc. 2017; 80: 366-370.17. Pryor JL, Kuneck PH, Blatz SM, Thorp C, Cornwell CE, Carrell DT. Delayed timing of intrauterine insemination results in a significantly improved pregnancy rate in female partners of quadriplegic men. Fertil Steril 2001; 76: 1130–1135.18. Kosmas IP, Tatsioni A, Fatemi HM, Kolibianakis EM, Tournaye H, Devroey P. Human chorionic gonadotropin administration vs. luteinizing monitoring for intrauterine insemination timing, after administration of clomiphene citrate: A meta-analysis. Fertil Steril 2007; 87: 607–612.

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

Year 2019, Volume: 50 Issue: 3, 108 - 111, 15.09.2019
https://doi.org/10.16948/zktipb.566761

Abstract

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.

Project Number

37-2019BADK/8-69

References

  • Referanslar:1. Dodson WC, Haney AF. Controlled ovarian hyperstimulation and intrauterine insemination for treatment of infertility. Fertil Steril 1991; 55: 457–467.2. Duran H, Mahmood M, Kruger T, Oehninger S. Intrauterine insemination: a systematic review on determinants of success. Hum Reprod Update 2002; 8: 373–384.3. ESHRE Capri Workshop Group. Intrauterine insemination. Hum Reprod Update 2009; 15: 265e77.4. Ragni G, Somigliana E, Vegetti W. Timing of intrauterine insemination: Where are we? Fertil Steril 2004; 82: 25–26.5. Cohlen BJ, te Velde ER, van Kooij RJ, Looman CW, Habbema JD. Controlled ovarian hyperstimulation and intrauterine insemination for treating male subfertility: A controlled study. Hum Reprod 1998; 13: 1553–1558.6. Jarvela IY, Tapanainen JS, Martikainen H. Improved pregnancy rate with administration of hCG after intrauterine insemination: A pilot study. Reprod Biol Endocrinol 2010; 8: 18.7. Aydin Y, Hassa H, Oge T, Tokgoz VY. A randomized study of simultaneous hCG administration with intrauterine insemination in stimulated cycles. Eur J Obstet Gynecol Reprod Biol 2013; 170: 444–448.8. Tonguc E, Var T, Onalan G, Altinbas S, Tokmak A, Karakaş N, Gulerman C. Comparison of the effectiveness of single versus double intrauterine insemination with three different timing regimens. Fertil Steril. 2010; 94: 1267-1270.9. Cooper TG, Noonan E, von Eckardstein S. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010; 16: 231–245.10. 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; 93: 79–88.11. Demir B, Dilbaz B, Cinar O, Karadag B, Tasci Y, Kocak M, Dilbaz S, Goktolga U. Factors affecting pregnancy outcome of intrauterine insemination cycles in couples with favourable female characteristics. J Obstet Gynaecol 2011; 31: 420–423.12. World Health Organization, Task Force on Methods for the Determination of the Fertile Period, Special Programme of Research, Development and Research Training in Human Reproduction. Temporal relationships between ovulation and defined changes in the concentration of plasma estradiol-17 beta, luteinizing hormone, follicle-stimulating hormone, and progesterone. I. Probit analysis. Am J Obstet Gynecol 1980; 138: 383–390.13. Ghanem ME, Bakre NI, Emam MA, Al Boghdady LA, Helal AS, Elmetwally AG, Hassan M, Albahlol IA, Elzayat MM. The effects of timing of intrauterine insemination in relation to ovulation and the number of inseminations on cycle pregnancy rate in common infertility etiologies. Hum Reprod 2011; 26: 576–583.14. Lee J, Hwang S, Lee J, Yoo J, Jang D, Hwang K, Kim M. Effect of insemination timing on pregnancy outcome in association with female age, sperm motility, sperm morphology and sperm concentration in intrauterine insemination. J Obstet Gynaecol Res. 2018; 44: 1100-1106. 15. Lemmens L, Kos S, Beijer C, Brinkman JW, van der Horst FA, van den Hoven L, Kieslinger DC. Predictive value of sperm morphology and progressively motile sperm count for pregnancy outcomes in intrauterine insemination. Fertil Steril 2016; 105: 1462–1468.16. Yumusak OH, Kahyaoglu S, Pekcan MK, Isci E, Cinar M, Tasci Y. Does intrauterine insemination timing matter for achieving pregnancy during ovulation induction using gonadotropins? A retrospective cohort study. J Chin Med Assoc. 2017; 80: 366-370.17. Pryor JL, Kuneck PH, Blatz SM, Thorp C, Cornwell CE, Carrell DT. Delayed timing of intrauterine insemination results in a significantly improved pregnancy rate in female partners of quadriplegic men. Fertil Steril 2001; 76: 1130–1135.18. Kosmas IP, Tatsioni A, Fatemi HM, Kolibianakis EM, Tournaye H, Devroey P. Human chorionic gonadotropin administration vs. luteinizing monitoring for intrauterine insemination timing, after administration of clomiphene citrate: A meta-analysis. Fertil Steril 2007; 87: 607–612.
There are 1 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Samettin Çelik

Banuhan Şahin 0000-0002-8711-1584

Aysemin Gürçeğlar

Canan Soyer

Şafak Hatırnaz

Project Number 37-2019BADK/8-69
Publication Date September 15, 2019
Published in Issue Year 2019 Volume: 50 Issue: 3

Cite

APA Çelik, S., Şahin, B., Gürçeğlar, A., Soyer, C., et al. (2019). HCG uygulamasından 36 saat ile 42 saat sonra yapılan intrauterin inseminasyonların klinik sonuçlarının karşılaştırılması. Zeynep Kamil Tıp Bülteni, 50(3), 108-111. https://doi.org/10.16948/zktipb.566761
AMA Çelik S, Şahin B, Gürçeğlar A, Soyer C, Hatırnaz Ş. HCG uygulamasından 36 saat ile 42 saat sonra yapılan intrauterin inseminasyonların klinik sonuçlarının karşılaştırılması. Zeynep Kamil Tıp Bülteni. September 2019;50(3):108-111. doi:10.16948/zktipb.566761
Chicago Çelik, Samettin, Banuhan Şahin, Aysemin Gürçeğlar, Canan Soyer, and Şafak Hatırnaz. “HCG uygulamasından 36 Saat Ile 42 Saat Sonra yapılan Intrauterin inseminasyonların Klinik sonuçlarının karşılaştırılması”. Zeynep Kamil Tıp Bülteni 50, no. 3 (September 2019): 108-11. https://doi.org/10.16948/zktipb.566761.
EndNote Çelik S, Şahin B, Gürçeğlar A, Soyer C, Hatırnaz Ş (September 1, 2019) HCG uygulamasından 36 saat ile 42 saat sonra yapılan intrauterin inseminasyonların klinik sonuçlarının karşılaştırılması. Zeynep Kamil Tıp Bülteni 50 3 108–111.
IEEE S. Çelik, B. Şahin, A. Gürçeğlar, C. Soyer, and Ş. Hatırnaz, “HCG uygulamasından 36 saat ile 42 saat sonra yapılan intrauterin inseminasyonların klinik sonuçlarının karşılaştırılması”, Zeynep Kamil Tıp Bülteni, vol. 50, no. 3, pp. 108–111, 2019, doi: 10.16948/zktipb.566761.
ISNAD Çelik, Samettin et al. “HCG uygulamasından 36 Saat Ile 42 Saat Sonra yapılan Intrauterin inseminasyonların Klinik sonuçlarının karşılaştırılması”. Zeynep Kamil Tıp Bülteni 50/3 (September 2019), 108-111. https://doi.org/10.16948/zktipb.566761.
JAMA Çelik S, Şahin B, Gürçeğlar A, Soyer C, Hatırnaz Ş. HCG uygulamasından 36 saat ile 42 saat sonra yapılan intrauterin inseminasyonların klinik sonuçlarının karşılaştırılması. Zeynep Kamil Tıp Bülteni. 2019;50:108–111.
MLA Çelik, Samettin et al. “HCG uygulamasından 36 Saat Ile 42 Saat Sonra yapılan Intrauterin inseminasyonların Klinik sonuçlarının karşılaştırılması”. Zeynep Kamil Tıp Bülteni, vol. 50, no. 3, 2019, pp. 108-11, doi:10.16948/zktipb.566761.
Vancouver Çelik S, Şahin B, Gürçeğlar A, Soyer C, Hatırnaz Ş. HCG uygulamasından 36 saat ile 42 saat sonra yapılan intrauterin inseminasyonların klinik sonuçlarının karşılaştırılması. Zeynep Kamil Tıp Bülteni. 2019;50(3):108-11.