Ultrasound guidance versus the blind method for intrauterine catheter insemination: A randomized controlled trial (original) (raw)
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Clinical and Experimental Obstetrics & Gynecology, 2015
This study was performed to determine the effects of ultrasound (US) guidance during intrauterine insemination (IUI) on pregnancy rate. Materials and Methods. This study is a prospective randomized controlled trial which was performed in Women's Health Research and Education Hospital, Infertility Unit. The study enrolled 130 couples who were scheduled to undergo IUI. The couples were randomized according to a computer-generated list into two groups; 1) the ultrasound-guided IUI group included 64 couples (n = 64) treated for 99 cycles 2) blind IUI group included 66 couples (n = 66) treated for 104 cycles. All women underwent controlled ovarian stimulation before IUI. The study's main measurements were pregnancy rate per cycle; pregnancy rate per woman. Results: The pregnancy rates were similar in both the ultrasound-guided (USG)(16.2%, 16/99) and non-ultrasound-guided (NUSG)(12.5%, 13/104) groups (p = 0.386). Conclusions: The present results suggest a routine ultrasound guidance during IUI is not essential as it does not increase pregnancy rates but it can be used in such cases to overwhelm some sort of difficulties.
Journal of Medical Sciences and Health, 2015
Objective: To investigate the role of trans-abdominal ultrasound (TAS) guidance in intrauterine insemination (IUI). Materials and Methods: A multicentre retrospective study was conducted at three centres in Bangalore, Karnataka from November 2012 and December 2014. 146 couples with unexplained infertility and mild male factor infertility were randomized using a computer-generated random numeric table into two groups: Group 1 who underwent TAS-guided IUI (n =73) and Group 2 who underwent classical blind IUI (n =73). 480 IUI cycles were performed for both the groups in total. Results: Of the 480 IUI cycles, 228 were carried out as TAS-guided, while 252 cycles were performed as the classical blind procedure. The difference in pregnancy rates of Group 1 and Group 2 was statistically significant (22.9 and 10.6% respectively (P = 0.00036), thereby indicating that TAS-guidance significantly improves pregnancy rates in IUI. In Group 1, 10.8% cases were difficult whereas in Group 2, 31.2% cases were difficult (P = 0.00001). Conclusion: TAS-guidance in IUI significantly improves pregnancy rates and reduces the frequency of difficult IUI.
Medical Principles and Practice, 2013
Objective: To investigate the role of ultrasound guidance in intrauterine insemination (IUI). Materials and Methods: A retrospective study was conducted. The data was collected from the records of 197 couples with unexplained infertility who underwent IUI with a total of 267 IUI cycles in the in vitro fertilization center of our hospital between January 2009 and December 2010. Results: Of the 267 IUI cycles, 145 were carried out as US-guided, while 122 cycles IUI were performed with a blind procedure. In the US-guided IUI and blinded IUI groups, the pregnancy rates were 23.4 and 13.9%, respectively. The difference between the groups was statistically significant (p = 0.049), thereby indicating that US guidance improves pregnancy rates. In the US-guided IUI group, 9.7% of the cases were difficult, while in the blinded IUI group, 26.2% were difficult and the difference between the groups was also statistically significant (p < 0.001). Conclusion: US guidance in IUI improves pregnan...
Ultrasound-Guided Artificial Insemination: a Randomized Controlled Trial
Human …, 2009
RESULTS: The PR was 16.0% per cycle in ultrasound-guided IUI and 16.8% in the control group, no statistically significant differences being observed between the groups. The 95% confidence interval for the difference in PRs of 0.8% was 8.8 to 10. There were no differences in PR ...
Influence of Catheter Type and Tenaculum Use on Intrauterine Insemination Outcome
Volume 14, No 3, October-December , 2020
Background: We investigated the impact of the choice of catheter type and tenaculum use on pregnancy related outcomes in intrauterine insemination (IUI) treatments. Materials and Methods: A total of 338 consecutive IUI cycles were assessed in this retrospective study. Participants were divided according to the insemination technique - soft catheter (group 1; n=175), firm catheter (group 2; n=100), or tenaculum (group 3; n=63). Clinical, laboratory, semen parameters and pregnancy related outcomes were compared. Results: Demographic characteristics and laboratory parameters were similar between the groups (P>0.05). The clinical pregnancy rate (CPR) was significantly higher in the firm catheter (19%, 19/100) and tenaculum (31.7%, 20/63) groups compared to the soft catheter group (5.1%, 9/175, P<0.001). There were no significant differences between the groups in live birth and miscarriage rates per clinical pregnancy (P>0.05). Conclusion: Our findings indicate that the use of a firm catheter or tenaculum for IUI might result in a higher CPR, but might not have a considerable effect on the live birth rate (LBR). Further prospective randomized studies are required to determine the long-term effects of the catheter type or tenaculum use on IUI success.
Human Reproduction, 2006
BACKGROUND: This study was done to test the hypothesis that intrauterine insemination (IUI) using a soft-tip catheter results in a higher live birth rate than IUI using a hard-tip catheter. METHODS: Five hundred and forty patients were randomized into those inseminated with a soft-tip catheter (group 1, n = 267) and those inseminated with a hard-tip catheter (group 2, n = 269). Four patients were excluded. Main outcome measures included pregnancy rate and live birth rate per cycle. RESULTS: Both groups were similar with regard to female age, duration of infertility, ovarian stimulation and sperm quality. No significant differences were observed between group 1 and group 2 regarding clinical pregnancy rate per cycle (20 versus 19%), live birth rate per cycle (15 versus 14%), multiple live birth rate per cycle (4 versus 6%) and multiple live birth per total of live births (5 versus 8%, overall 6%), respectively. CONCLUSION: Our hypothesis that IUI using a soft tip catheter results in a higher live birth rate per cycle than IUI using a hard-tip catheter was not confirmed in this study. Multiple live birth rate after treatment with low-dose gonadotrophins and IUI can be kept low (6%).
Clinical Assisted Reproduction Does Catheter Type Effect Pregnancy Rate in Intrauterine
2001
Purpose: To determine if a soft insemination catheter increases pregnancy rates. Methods: Seven hundred forty-seven consecutive intrauterine insemination (IUI) cycles in 364 women in a reproductive endocrinology office between October 1998 and March 2000. Patients with even birth years were inseminated with the Tomcat catheter, and those with odd birth year with the Wallace IUI catheter. Clinical pregnancy rates were compared. Results: The Wallace catheter group included 180 women for 372 cycles and an overall preg-nancy rate of 16.4%. The Tomcat catheter group included 184 women for 375 cycles and an overall pregnancy rate of 18.1%. This difference is not statistically significant (P D 0:61). Potential confounders were accounted for. Conclusions: When comparing the softer Wallace catheter to the less pliable Tomcat catheter during IUI cycles, there was no significant difference in pregnancy rate when using a standard gentle technique that includes not touching the top of the fundus...
Factors predicting the outcome of intrauterine insemination
The Medical Journal of Basrah University, 2012
Background: Intrauterine insemination (IUI) is a frequently indicated therapeutic modality in infertility and considered to be of low to moderate complexity before the application of more sophisticated assisted reproductive technologies (ART). It is simple and inexpensive treatment in which processed and concentrated motile sperm are placed directly into uterine cavity. IUI is used together with various controlled ovarian hyperstimulation (COH) protocols for many indications such as male infertility, ovulatory disorders, endometriosis and unexplained infertility. Aim of study: Is to identify the important prognostic variables contributing to the successful outcome. Patients and methods: A prospective study was carried out at Assisted Conception Unit of Basra Medical College, A total of 203 cycles were analyzed to identify prognostic factors regarding treatment outcome. The variables selected for analysis were female age, duration and etiology of infertility, sperm parameters, number of preovulatory follicles, and number of previous treatment cycles and the method of COH. Results: The overall pregnancy rate per cycle was 9.3% (19/203). Of 19 pregnancies, 68.4% resulted in live birth, 26.3% in spontaneous abortion, and 5.3% were ectopic pregnancy. The multiple pregnancy rate was 15.8 % (3 twin pregnancies). Three significant variables for successful outcome were total motile sperm count (>10x10 6), the method of ovarian stimulation (use of r-FSH alone being superior to Clomiphen Citrate (CC) with r-FSH and CC alone), and multifollicular response. There was a tendency to a higher pregnancy rate in women <40 years and shorter duration of infertility (< 5 years) but this did not reach a statistical significance. Significant difference was not observed among different etiologies, although lowest pregnancy rate was found in unexplained infertility group. Conclusion: IUI may be an option for a selected group of couples prior to considering more sophisticated and expensive assisted reproductive techniques. High total motile sperm count (>10x10 6), controlled ovarian hyperstimulation (COH) with r-FSH and multifollicular response are valuable predictors for pregnancy in COH-IUI cycle.
International Journal of Infertility & Fetal Medicine, 2016
Deciding optimum stimulation protocols is one of the most important factors for the success of any assisted reproductive technologies. We have used ultrasound parameters chiefly with age and basal mass index (BMI) to decide stimulation protocols in intrauterine insemination (IUI) cycles. The parameters used on ultrasound were ovarian size (volume), number of antral follicles, ovarian stromal resistance index, and peak systolic velocity. A scoring system was developed according to the values of these parameters with age and BMI of the patient. This scoring system has been used to decide the dose of gonadotropins for superovulation in IUI cycles. It has been used for 1570 patients with cancellation of cycles due to poor response in only one patient and moderate ovarian hyperstimulation syndrome in only one patient. This shows that the scoring system has been very effective for deciding optimum stimulation protocols in patients with varying age, BMI, and ovarian reserve.
A Study of Predictive Factors Affecting Outcome of Intrauterine Tuboperitoneal Insemination
2017
Infertility management has become more substantial and relevant with an increase in the number of infertile patients as well as advances in the science of reproduction. The objective of our study was to assess the factors predicting the treatment outcome of a new assisted reproductive technique, intrauterine tuboperitoneal insemination (IUTPI) in the treatment of infertile patients. 118 cases, after applying both inclusion and exclusion criteria were enrolled in the study. Patients were given clomiphene citrate for ovarian stimulation followed by injection human chorionic gonadotropin for triggering ovulation. Insemination was then performed with washed husband’s sperm after about 36-40 hours, using 10ml of inseminate. The patient was then called after 2 weeks for urine pregnancy test which, if positive was considered as clinical pregnancy. Out of 118 cases, 27 cases were positive. The pregnancy rate was 22.88%. Endometrial thickness, preovulatory follicle number, prewash sperm moti...