Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success.

Abstract

PURPOSE:

To report our experience on homologous intrauterine insemination (IUI) with gonadotropin controlled ovarian stimulation (COS) cycles and to examine different variables which could predict IUI success.

MATERIALS AND METHODS:

This is a retrospective analysis of IUIs performed between January 1997 and December 2017. A total of 7359 COS IUI's procedures (2901 couples) were reviewed. Clinical pregnancy, live birth rate and age, body mass index (BMI), smoking habit, duration of infertility, sperm characteristics before and after treatment (total motile count, morphology, and vitality), day 3 FSH, total gonadotropin dose, and number of follicles were assessed by multivariate logistic regression analysis, and data were expressed as odds ratio (OR).

RESULTS:

The mean female age at the time of COS was 35.10 ± 3.93 years. The most common single infertility diagnoses were unexplained infertility (53.55%), mild male factor (19.69%), and anovulation (10.95%). The total progressive motile sperm count (TPMC) was > 1 × 106/ml (mean 1.34 ± 1.08 × 106/ml). The clinical pregnancy rate was 9.38%, and the live birth rate was 7.19% per cycle. Twin pregnancies were 12.17%. Cumulative pregnancy was 21.89% and cumulative live birth rate was 17.58% per couple. Clinical pregnancy and live birth rates were significantly associated with female age [OR 0.97 (95% CI 0.95-0.99) and 0.95 (95% CI 0.93-0.97), respectively] and day 3 FSH [OR 0.91 (95% CI 0.87-0.94) e 0.90 (95% CI 0.87-0.94), respectively].

CONCLUSIONS:

Clinical pregnancy rate and live birth rates after COS-IUIs were significantly influenced by female age and FSH levels.

TRIAL REGISTRATION:

Clinical trial registration number: NCT03836118.

• Authors: Valentina Immediata, Pasquale Patrizio, Maria Rosaria Parisen Toldin, Emanuela Morenghi, Camilla Ronchetti, Federico Cirillo, Annamaria Baggiani, Elena Albani, Paolo Emanuele Levi-Setti
• Journal: Journal of assisted reproduction and genetics (J Assist Reprod Genet) Vol. 37 Issue 5 Pg. 1195-1201 (May 2020) ISSN: 1573-7330 [Electronic] Netherlands
• PMID: 32215826 (Publication Type: Journal Article)

Chemical References

• Gonadotropins

Topics

• Adult
• Female
• Fertilization in Vitro
• Gonadotropins (therapeutic use)
• Humans
• Infertility, Female (physiopathology, therapy)
• Insemination, Artificial
• Live Birth (epidemiology)
• Male
• Maternal Age
• Ovarian Follicle (growth & development, metabolism, pathology)
• Ovulation Induction
• Pregnancy
• Pregnancy Rate
• Prognosis
• Spermatozoa (growth & development, pathology)