OBJECTIVETo evaluate the effects of catheter depth and infused semen volume on the pregnancy rate of intrauterine insemination(IUI) with the husband's semen.

METHODSAccording to different catheterizing distances from the fundus and infused semen volumes, 330 patients undergoing intrauterine insemination were randomly divided into 6 groups: A, 1 cm/0.5 ml; B, 1 cm/0.3 ml; C, 2 cm/0.5 ml; D, 2 cm/0.3 ml; E, 3 cm/0.5 ml and F, 3 cm/0.3 ml. The pregnancy rate was investigated in each group.

RESULTSThe pregnancy rates from group A to group E were 9.09% (5/55), 12.73% (7/55), 10.91% (6/55), 29.09% (16/55), 9.09% (5/55) and 12.73% (7/55), respectively. It was significantly higher in group D than in groups A, B, C, E and F(P < 0.05).

CONCLUSIONSCatheterizing distance of 2 cm from the fundus with infused semen volume of 0.3 ml can significantly improve pregnancy rate in patients undergoing IUI with the husband's semen.

Adult ; Catheterization ; methods ; Female ; Humans ; Infertility ; therapy ; Insemination, Artificial, Homologous ; methods ; Male ; Pregnancy ; Pregnancy Rate ; Semen

Objective: To analyze the correlation of the sperm DNA fragmentation index (DFI) level with semen parameters and pregnancy outcomes of artificial insemination of the husband (AIH) in the cycle of intrauterine insemination (IUI). METHODS: We collected the clinical data on 777 cases of IUI, including female clinical indicators, male semen parameters, sperm DFI and pregnancy outcomes. According to the DFI level, we divided the patients into three groups: DFI < 15%, 15% ≤ DFI < 30% and DFI ≥ 30%. RESULTS: The sperm DFI level was significantly elevated with the increased age of the males (P = 0.002) and closely related to the total number of motile sperm (P = 0.002) and total sperm motility (P = 0.000) before treatment, as well as to sperm concentration (P = 0.000), total sperm motility (P = 0.001) and total number of progressively motile sperm (P = 0.000) after density gradient centrifugation. The rate of clinical pregnancy was decreased in the DFI ≥ 30% group. There were no statistically significant differences between sperm DFI and the rates of clinical pregnancy and abortion. CONCLUSIONS Male age significantly affects the sperm DFI level. Sperm DFI is closely related to sperm motility and total number of progressively motile sperm, but not to the rates of clinical pregnancy and abortion in patients undergoing IUI. IUI can be used as an effective method of assisted reproduction for male infertility./.
DNA Fragmentation ; Female ; Humans ; Insemination, Artificial, Homologous ; Male ; Pregnancy ; Pregnancy Outcome ; Semen ; Sperm Motility ; Spermatozoa

OBJECTIVETo explore the application value of semen cryopreservation in intrauterine insemination cycles for the treatment of oligospermia and asthenospermia in infertile males.

METHODSA total of 152 cycles of intrauterine insemination were performed for 103 couples with constitutional infertility, which were divided into Groups 1 (normal semen, n=53), 2 (oligospermia and asthenospermia, n=52) and 3 (fresh combined with cryopreserved semen, n=47). Semen parameters and forward motile sperm count after processing were recorded by Makler chamber, and all were followed up for the outcome of clinical pregnancy.

RESULTSCompared with Group 2, Group 3 showed obviously lower semen volume, sperm motility and grade a sperm count before semen processing, with extremely significant differences (P < 0.01), but a higher rate of grade a sperm after semen processing, though with no significant differences (P > 0.05). There were no statistically significant differences in the pregnancy rate between Groups 2 and 3 (9.6% versus 14.9%, P > 0.05).

CONCLUSIONSemen cryopreservation can improve the forward motile sperm count and pregnancy rate in oligospermia and asthenospermia patients after intrauterine insemination. Semen cryopreservation combined with intrauterine insemination seems an ideal treatment for oligospermia and asthenospermia in infertile men.

Asthenozoospermia ; therapy ; Cryopreservation ; Female ; Humans ; Infertility, Male ; therapy ; Insemination, Artificial, Homologous ; methods ; Male ; Oligospermia ; therapy ; Pregnancy ; Pregnancy Rate

OBJECTIVETo evaluate the effect of superovulation with recombinant follicle stimulating hormone (r-FSH) therapy and intrauterine insemination in the treatment of idiopathic infertility.

METHODSSuperovulation with r-FSH therapy and intrauterine insemination were used in 202 cycles of 88 couples in the Department of Obstetrics and Gynecology of Monash Medical Centre.

RESULTSThe per cycle ovulation rate and in-ovulation rate were 95.7% and 4.3% respectively, and the per cycle pregnancy rate was 11.6% with no cases of hyperstimulation. The cancelling rate was 7.4% because of the development of multiple follicles. The overall cumulative conception rate was 22.7% per patient, with 15% of twin pregnancies. There were no differences between pregnancy group and non-pregnancy group in age, BMI, treatment days, number of mature follicles, endometrial thickness and number of treatment cycles. The only significant parameter observed between the two groups was infertility time (P < 0.05), which was longer in non-pregnancy group [(30.52 +/- 13.08) months] than in pregnancy group [(24.25 +/- 6.45) months].

CONCLUSIONSSuperovulation and intrauterine insemination is a safe and more cost-effective method in treatment of idiopathic infertility.

Adult ; Female ; Follicle Stimulating Hormone, Human ; biosynthesis ; genetics ; therapeutic use ; Humans ; Infertility, Female ; therapy ; Insemination, Artificial, Homologous ; methods ; Recombinant Proteins ; biosynthesis ; genetics ; therapeutic use ; Superovulation ; drug effects

OBJECTIVETo compare the results of the natural cycle and ovulation induction cycle in intrauterine insemination (IUI) for infertile couples of different ages.

METHODSWe retrospectively analyzed 746 IUI cycles for 363 infertile couples, who were divided into a natural cycle (NC) and an ovulation induction cycle (OIC) group. The two groups were respectively subdivided into a < 35 yr and a > or = 35 yr age group, and, according to the drugs used, the OIC group was again divided into subgroups of clomiphene citrate + Progynova (CC + P), menopausal gonadotropin (HMG) and CC + HMG. The rates of clinical pregnancy, abortion and delivery were compared among different groups.

RESULTSThe pregnancy rate was significantly lower in the NC than in the OIC group (11.35% versus 19.61%, P < 0.01), but the rates of abortion and delivery had no significant differences between the two groups (P > 0.05), nor did the rate of clinical pregnancy among the subgroups of CC + P, HMG and CC + HMG (18.00%, 25.00% and 19.35%, P > 0.05). The < 35-year-old patients showed statistically lower rates of pregnancy and delivery in the NC than in the OIC group (P < 0.01 and P < 0.05), while the > or = 35-year-olds exhibited no significant differences in the rates of clinical pregnancy, abortion and delivery between the two groups.

CONCLUSIONThe ovulation induction cycle could achieve a higher pregnancy rate than the natural cycle in IUI, whether with CC + P, HMG or CC + HMG, particularly for the infertile patients under 35 years. But the natural cycle is preferable for the > or = 35-year-olds.

Adult ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; therapy ; Infertility, Male ; therapy ; Insemination, Artificial, Homologous ; methods ; Male ; Ovulation Induction ; methods ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Young Adult

OBJECTIVETo determine an optimal insemination technique for unexplained infertility patients undergoing IVF or ICSI following failed intrauterine insemination (IUI).

METHODSSixty-five cycles of 61 patients with failed IUI were divided into four groups: Group A (37 cycles of IVF), Group B (19 cycles of ICSI), Group C (4 cycles of IVF and ICSI: half and half), Group D (5 cycles of ICSI after failed IVF). The conventional IVF cycles were defined as Group E (37 cycles), and the conventional ICSI cycles defined as Group F (24 cycles). The fertilization rate, completely failed fertilization rate, high quality embryo rate, clinical pregnancy rate and the implantation rate were compared among all the groups.

RESULTSThere were statistically significant differences in the fertilization rate, completely failed fertilization rate between Groups A and E (55.4% vs 72.8%, P < 0.05; 21.6% vs 0%, P < 0.005), and Groups A and B (55.4% vs 68.4%, P < 0.05; 21.6% vs 0%, P < 0.01). In Group D, there was statistically significant difference in the fertilization rate between IVF cycles and ICSI cycles (12.2% vs 74.2%, P < 0.005).

CONCLUSIONThe present study demonstrates that there may be 20% of totally failed fertilization in IVF cycles with unexplained primary infertility following failed IUI, and ICSI treatment can increase fertilization rate and avoid complete fertilization failure.

Adult ; Female ; Humans ; Infertility, Female ; etiology ; therapy ; Insemination, Artificial, Homologous ; methods ; Male ; Ovulation Induction ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; methods ; Treatment Failure

OBJECTIVETo analyze and compare the pregnancy rates of intrauterine insemination (IUI) achieved by 3 optimized methods of separating high-quality sperm.

METHODSThe data from 452 infertile couples who underwent 671 IUI cycles in our reproductive medicine center were retrospectively analyzed. The patients were divided into three groups: 5% HSA Earle's swim-up, SpermRinse swim-up and SupraSperm density gradient centrifugation according to different methods for separating high-quality sperm, and the clinical pregnancy rates were compared.

RESULTSIn the 5% HSA Earle's swim-up group, 21 pregnancies were achieved in 221 cycles (9.5%) and in the SpermRinse swim-up group, 34 in 215 cycles (15.8%), with a significantly higher rate in the latter than in the former (P < 0.05). In the SupraSperm density gradient centrifugation group, there were 34 pregnancies in 235 cycles (14.5%), with no statistically significant difference from the other two groups (P > 0.05).

CONCLUSIONThe SpermRinse swim-up method can improve the clinical pregnancy rate and is suitable for various types of sterile patients. SupraSperm density gradient centrifugation, as an effective method available for separating high-quality sperm, is particularly suitable for those with lots of inflammatory cells and dead and abnormal sperm in the semen.

Adult ; Centrifugation, Density Gradient ; Female ; Humans ; Infertility, Female ; therapy ; Insemination, Artificial, Homologous ; methods ; Male ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sperm Count ; Sperm Motility

OBJECTIVETo investigate the influence of the time interval from the end of semen processing to artificial intrauterine in semination with husband's sperm (AIH-IUI) on the rate of clinical pregnancy.

METHODSThis study involved 191 AIH-IUI cycles with the same ovulation induction protocol. After Percoll density gradient centrifugation, we divided the sperm into four groups based on the incubation time: 0-19, 20-39, 40-59, and 60-80 min, and again into another four groups according to the total progressively motile sperm count (TPMC): (0-9), (10-20), (21-30), and > 30 x 10(6). We analyzed the correlation of the clinical pregnancy rate with the time interval from the end of sperm processing to AIH-IUI and with other influencing factors, such as maternal age, infertility duration, and semen quality.

RESULTSThe rate of clinical pregnancy was significantly higher in the 20-39 min group (18.3%) than in the 0-19, 40-59, and 60-80 min groups (12.7, 11.4 and 9.1%) (all P < 0.05). The (10-20) x 10(6) group achieved a remarkably higher pregnancy rate (16.7%) than the (0-9), (21-30), and > 30 x 10(6) groups (0, 11.4, and 8.3%) (all P < 0.05). Logistic multivariate analysis showed that the rate of clinical pregnancy was decreased with the increased age of the women (OR 0.89, 95% CI 0.83-0.94) but significantly elevated in the 20-39 min group (OR 2.11, 95% CI 1.34-3.13) and of (10-20) x 10(6) group (OR 2.06, 95% CI 1.32-3.46).

CONCLUSIONThe time interval from the end of sperm processing to AIH-IUI is a most significant factor influencing the rate of clinical pregnancy of AIH-IUI.

Centrifugation, Density Gradient ; Female ; Humans ; Infertility ; therapy ; Insemination, Artificial, Homologous ; statistics & numerical data ; Male ; Pregnancy ; Pregnancy Rate ; Semen ; Semen Analysis ; Sperm Count ; Spermatozoa ; Time Factors

OBJECTIVE: To investigate the relationship between sperm acrosome reaction (AR) and the clinical pregnancy rate of intrauterine insemination (IUI). METHODS: We detected the sperm spontaneous AR rate and Ca2+ ionophore A23187-induced AR rate in 128 patients who accepted IUI treatment, collected their clinical data and analysed the relationship between sperm AR rate and clinical pregnancy rate of IUI. RESULTS: There was no statistical difference between the spontaneous AR rates in the pregnant group and the non-pregnant group (7.7% vs. 7.0%, P>0.05), but there was statistical difference between the induced AR rates(51.9 % vs. 43.5%, P<0.05). There was statistical difference in the clinical pregnancy rate among the 3 IUI groups divided by induced AR rate (≤20.0%, 20.1%-49.9%, and ≥50.0%; 4.8% vs. 12.5% vs. 18.6%, P<0.05). CONCLUSION The spontaneous AR rate has nothing to do with the clinical pregnancy rate of IUI, but the induced AR rate is associated with the clinical pregnancy rate of IUI.
Acrosome Reaction ; drug effects ; physiology ; Adult ; Calcimycin ; pharmacology ; Female ; Humans ; Infertility ; therapy ; Insemination, Artificial, Homologous ; methods ; Male ; Pregnancy ; Pregnancy Rate ; Spermatozoa ; physiology

PURPOSE: The association between tenaculum application to the cervix just before embryo transfer and lower pregnancy rate has been reported. However, studies on the use of tenaculum in intrauterine insemination (IUI) cycles are not available. This study attempted to investigate whether the use of tenaculum affects the clinical outcomes of IUI. MATERIALS AND METHODS: Two hundred and thirty three CC/hMG/IUI cycles of one hundred and forty three couples were recruited at Seoul National University Hospital from October 2006 to December 2008. Mock insemination and IUI with or without tenaculum application to the cervix were also performed, and clinical pregnancy rate was compared. RESULTS: The incidence of difficult mock insemination at the beginning of cycle was higher in the tenaculum use group (p < 0.001). No significant statistical difference in the clinical pregnancy rate was observed between the groups with or without tenaculum application (12.1% vs. 18.5%; p = 0.175), which was not influenced by the difficulty of mock insemination. CONCLUSION: The use of tenaculum during IUI may not affect the pregnancy outcome. Our results need to be confirmed by a prospective study in a larger population.
Adult ; Cervix Uteri/*physiopathology ; Female ; Hormones/blood ; Humans ; Incidence ; Infertility, Female/physiopathology/*therapy ; Insemination, Artificial, Homologous/*instrumentation ; Male ; Ovary/physiology ; Ovulation Induction ; Physical Stimulation/instrumentation ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Treatment Outcome ; Uterine Contraction/*physiology