The Use of Tenaculum During Intrauterine Insemination May Not Affect the Pregnancy Outcome (original) (raw)
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Human Reproduction, 1997
Another substantial advantage of these techniques is the removal of non-motile spermatozoa, leukocytes and immature 4 To whom correspondence should be addressed germ cells. This might contribute to enhanced sperm quality This retrospective study aimed to evaluate the prognostic by decreased release of lymphokines and/or cytokines and a value of the inseminating motile count (IMC) and sperm reduction in the formation of free oxygen radicals after sperm morphology (using strict criteria) on success rates after preparation. This results in better sperm fertilizing ability homologous intrauterine insemination (IUI) combined with in vitro and in vivo (Aitken and Clarkson, 1987). Finally, this clomiphene citrate (CC) stimulation. A total of 373 couples may lead to higher success rates after IUI in male subfertility underwent 792 IUI cycles in a predominantly (87.4%) male cases, as described previously by and subfertility group. The overall cycle fecundity (CF) and Ombelet et al. (1995b). baby take-home rate (BTH) was 14.6 and 9.9% respectively.
The effect of ovarian stimulation on the outcome of intrauterine insemination
Archives of Gynecology and Obstetrics, 2013
Purpose Although intrauterine insemination is one of the oldest techniques in reproductive medicine, its significance is still controversially discussed. Many factors have been reported as influencing pregnancy rates after IUI. The aim of this retrospective analysis is to evaluate the success rate of repeated inseminations depending on the type of ovarian stimulation. Methods Patients who underwent intrauterine insemination in Wiesbaden Kinderwunschzentrum between 1998 and 2010, not older than 45 years of age, with male subfertility were included in this study. On the whole, 5,346 inseminations on 2,180 patients were analyzed retrospectively. Results Females' mean age was 34.1, ranging from 19-45 years. In 433 cycles an insemination was performed during a natural cycle. 4,020 cycles were stimulated with recombinant FSH, 596 cycles with clomiphene, 194 with urinary FSH, 103 with HMG. The pregnancy rates range from 7.4 % in the clomiphene group to 14.4 % in the urinary FSH group. Clomiphene stimulation seems to offer the significantly lowest pregnancy rate (p = 0.03). The other types of stimulation do not differ significantly from each other concerning the pregnancy rate. Patients under 39 years of age do not profit from any ovarian stimulation. In 40 and more years of old patients, pregnancy rates are higher, if any stimulation was performed. Conclusion To sum up, clomiphene stimulation showed to offer significantly lower pregnancy rates in comparison to the natural cycle, FSH stimulation and HMG stimulation in IUI treatment. While women younger than 40 seem not to profit from any ovarian stimulation, women over 40 do profit. Keywords Intrauterine insemination Á Controlled ovarian stimulation Á Clomiphene citrate Á Follicle stimulating hormone Á Human menopausal gonadotropin Á Natural cycle Á Pregnancy rate R. Gomez and M. Schorsch contributed equally.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019
Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility.Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3-7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle. Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards.Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm i...
Objective: To determine whether minimal stimulation with clomiphene and one injection of 150 IU of human menopausal gonadotrophin (hMG) provides pregnancy rates comparable with those in a conventional full hMG stimulation protocol for unexplained infertile patients undergoing intrauterine insemination (IUI). Methods: A prospective study was carried out at the Infertility Clinic of Elshorok hospital Benha Egypt. Two hundred couples with either unexplained infertility or ovulatory dysfunction cases who ovulated with clomiphene citrate (CC) but failed to conceive were offered ovarian stimulation with CC and hMG along with IUI for 200 cycles. Patients divided into two groups according to the stimulation protocol in group one patients given clomiphene citrate 50mg from day 3 to 7 two tablets per day with hMG (merional )75 unit injection on day 5 and 7 .in group two (full stimulation regimen clomiphene citrate given with hMG injection from day 5 to 9 daily then dose adjusted according to finding on trans-vaginal ultrasound scan of follicles . Pregnancy rate, medication and monitoring cost were compared between minimal and conventional stimulation protocols. Results: Number of ampoules of hMG and monitoring costs were significantly higher in the full hMG stimulation cases whereas pregnancy rate was comparable in both protocols. Conclusion: Minimal stimulation appears to be an effective protocol in cases of unexplained infertility undergoing intrauterine insemination.
Intrauterine insemination treatment in subfertility: an analysis of factors affecting outcome
Human Reproduction, 1999
A total of 811 intrauterine insemination (IUI) cycles in which clomiphene citrate/human menopausal gonadotrophin (HMG) was used for ovarian stimulation were analysed retrospectively to identify prognostic factors regarding treatment outcome. The overall pregnancy rate was 12.6% per cycle, the multiple pregnancy rate 13.7%, and the miscarriage rate 23.5%. Logistic regression analysis revealed five predictive variables as regards pregnancy: number of the treatment cycle (P ⍧ 0.009), duration of infertility (P ⍧ 0.017), age (P ⍧ 0.028), number of follicles (P ⍧ 0.031) and infertility aetiology (P ⍧ 0.045). The odds ratios for age <40 years, unexplained infertility aetiology (versus endometriosis) and duration of infertility ≤6 years were 3.24, 2.79 and 2.33, respectively. A multifollicular ovarian response to clomiphene citrate/HMG resulted in better treatment success than a monofollicular response, and 97% of the pregnancies were obtained in the first four treatment cycles. The results indicate that clomiphene citrate/HMG/IUI is a useful and cost-effective treatment option in women <40 years of age with infertility duration ≤6 years, who do not suffer from endometriosis. Key words: clomiphene citrate/human menopausal gonadotrophin/infertility/intrauterine insemination/prognostic factors by guest on July 25, 2015 http://humrep.oxfordjournals.org/ Downloaded from
BMJ open, 2017
To study the effectiveness of four cycles of intrauterine insemination (IUI) with ovarian stimulation (OS) by follicle-stimulating hormone (FSH) or by clomiphene citrate (CC), and adherence to strict cancellation criteria. Randomised controlled trial among 22 secondary and tertiary fertility clinics in the Netherlands. 732 women from couples diagnosed with unexplained or mild male subfertility and an unfavourable prognosis according to the model of Hunault of natural conception. Four cycles of IUI-OS within a time horizon of 6 months comparing FSH 75 IU with CC 100 mg. The primary outcome is ongoing pregnancy conceived within 6 months after randomisation, defined as a positive heartbeat at 12 weeks of gestation. Secondary outcomes are cancellation rates, number of cycles with a monofollicular or with multifollicular growth, number of follicles >14 mm at the time of ovulation triggering, time to ongoing pregnancy, clinical pregnancy, miscarriage, live birth and multiple pregnancy....
Fertility and Sterility, 2007
To test the hypothesis that anovulatory women would have good pregnancy rates (PRs), regardless of single or multiple follicular development, in response to clomiphene citrate (CC), whereas ovulatory women would have good PRs only when achieving multifollicular responses to CC. Retrospective chart review. University-based infertility center. Two hundred and fifty-four women underwent 585 CC-IUI treatment cycles over a 3-year period. Treatment with CC-IUI. Various factors were examined as predictors of clinical pregnancy rate (CPR) and live-birth rate (LBR) per cycle with the use of logistic regression. Overall, the CPR was 11.1%, and the LBR was 8.7%. Of 65 clinical pregnancies, 81.5% resulted in live births (singletons, 67.7%; twins, 13.8%). There were no higher-order deliveries. In anovulatory women, the CPR and LBR were 15.7% and 13.6%, respectively. In ovulatory women, the CPR and LBR were 8.8% and 6.3%, respectively. As the number of large follicles increased from one to two, the LBR increased from 6.8% to 10.5%. Regarding the interaction of follicles with ovulatory status, anovulatory women had nearly double the CPR and LBR compared to those in ovulatory women, irrespective of the number of large follicles. Treatment with CC-IUI is more successful in anovulatory women than in ovulatory women. The multiple follicular response in both ovulatory and anovulatory women increases PRs.
Research Square (Research Square), 2023
Objective: There was also a lack of data regarding the effect of follicle size, endometrial thickness, and ovarian stimulation as predictors of intrauterine insemination (IUI) success rate in Indonesia, especially in the Aster Clinic and Bandung Fertility Centre. This study was performed to explore the relationship between follicle size, endometrial thickness, and types of ovarian stimulation (Clomiphene citrate/CC vs Letrozole) with biochemical pregnancy rate in women undergone IUI. We performed a case-control study in 122 women aged 20-40 years with unexplained infertility who had completed the IUI program for a maximum of three cycles. Data were extracted from medical records. Independent T-test and multivariate analyses were used to analyse the difference between variables using IBM SPSS 24.0. P-value < 0.05 was considered statistically signi cant. Result: Follicle sizes of 18-22 mm in both Clomiphene citrate (CC) and Letrozole groups were shown to increase biochemical pregnancy rate (P= 0.001). There is no relationship between endometrial thickness and pregnancy rate. Biochemical pregnancy rate in women using Letrozole was 1.513 times higher than women using CC. The follicle size of 18-22 mm and using Letrozole rather than CC as ovarian stimulators are predictive factors associated with a higher pregnancy rate in women undergone IUI.
Journal of Obstetrics & Gynaecology, 2007
This study is an audit of a new intrauterine insemination (IUI) programme in a low resource private fertility practice in southeast Nigeria. IUI was performed using a Wallace flexible catheter 1 day before or on the day of ovulation after ovarian stimulation with clomiphene citrate. The 18 couples treated had either male (16) or unexplained (2) infertility. The women were between 25 and 49 years and 13 (72.2%) of the couples had primary infertility while the duration of infertility ranged from 3 to 15 years. All the women had tubal patency confirmed by laparoscopy and dye test before undergoing IUI. The pregnancy rates per couple and per insemination cycle and the effect of maternal age and source of semen (partner or donor) were determined. The 18 couples had a total of 48 treatment cycles and five became pregnant (confirmed by early ultrasound scan) giving a pregnancy rate of 27.8% per couple or 10.4% per treatment cycle. The pregnancy rate was 41.7% per couple, 15.6% per treatment cycle for the donor group and 0% for the partner group ( p 5 0.01). Poor sperm quality was responsible for the poor pregnancy outcome in the partner group. The pregnancy rate per couple was 36.5% in women 5 35 years compared with 14.3% in those 35 years ( p ¼ 0.02). Similarly, the cycle pregnancy rate was significantly higher in women 5 35 years (16.0% vs 4.4%; p 5 0.02). There was one (20%) case of twin pregnancy and no miscarriage. Four of the women had a live birth (80%) at term and one had an intrauterine death following severe pre-eclampsia at 29 weeks' gestation. In conclusion, the overall couple and cycle pregnancy rates at our centre is comparable with the rates in many centres. Younger age and good quality semen are good indicators of a successful outcome. Infertile couples should therefore be evaluated early and recommended for this treatment option before advanced female age.
Obstetrics and gynecology international, 2009
Objective. There is an asymmetric allocation of technology and other resources for infertility services. Intrauterine insemination (IUI) is a process of placing washed spermatozoa transcervically into the uterine cavity for treatment of infertility. This is a review of literature for the potential use of IUI as a basic infertility treatment in technology-limited settings. Study design. Review of articles on treatment of infertility using IUI. Results. Aspects regarding the use of IUI are reviewed, including ovarian stimulation, semen parameters associated with good outcomes, methods of sperm preparation, timing of IUI, and number of inseminations. Implications of the finding in light of the needs of low-technology medical settings are summarized. Conclusion. The reviewed evidence suggests that IUI is less expensive, less invasive, and comparably effective for selected patients as a first-line treatment for couples with unexplained or male factor infertility. Those couples may be off...