OBJECTIVETo explore various factors affecting the clinical pregnancy outcomes of artificial insemination with donor sperm (AID).

METHODSWe retrospectively analyzed 15,744 cycles of AID in 6302 women and investigated the association of the clinical pregnancy outcomes of AID with the treatment protocols, the times of insemination per cycle, the age of the infertile women, the status of the oviduct, and the number of AID cycles.

RESULTSThe pregnancy rate of AID was higher in the chlomiphene-treated women than in those of the natural cycle group (P = 0.003) but showed no significant differences either between the chloramiphene and human menopause gonadotropin (HMG) or between the HMG and natural cycle groups (P > 0.05), and so was it in the women that had received AID twice per cycle before and after ovulation (26.3%) than in those that had undergone only once before (7.0%) or after ovulation (23.7%) (P < 0.05). However, the pregnancy rate was remarkably lower in the women aged 35-40 years (16.5%), especially in those over 40 years (1.2%), than in those under 35 years (26.0%) (P < 0.05). There was no significant difference in the success rate of AID between the women with oviductal adhesion and those without (27.4% vs. 28.1%, P > 0.05). The pregnancy rate of the first cycle of AID (27.6%) was markedly higher than those of the second (24.7%), third (23.9%), and fourth (23.1%) (P < 0.01), but with no significant differences among the latter three cycles (P > 0.05), while that of the fifth cycle (19.0%) was remarkably lower than those of the first four (P < 0.01).

CONCLUSIONThe age of the infertile women is an important factor affecting the success rate of AID. AID twice per cycle is better than once only. For those without oviductal factors, at least 4 cycles of AID are required before in vitro fertilization.

Adult ; Age Factors ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; Insemination, Artificial ; Insemination, Artificial, Heterologous ; Ovulation ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies

OBJECTIVETo investigate the clinical value of artificial insemination by donor (AID).

METHODSWe retrospectively analyzed 480 cycles of AID among 258 infertile couples, who were divided according to the women's age into a < or = 30 yr group and a > or = 31 yr group.

RESULTSA total of 120 pregnancies were achieved in 480 AID cycles, with a cycle pregnancy rate of 25.00% and a cumulative pregnancy rate of 46.51%. In the natural cycles, the cycle pregnancy rate was 29.65% and the cumulative pregnancy rate was 51.00% in the < or = 30 yr group, significantly higher than 13.33% and 25.00% in the > or = 31 yr group (P < 0.05). In the ovulation induction cycles, no significant differences were found in the cycle and cumulative pregnancy rates between the two groups (24.02 and 48.86% versus 23.81 and 43.48% , P > 0.05). The cycle and cumulative pregnancy rates decreased with the increase of infertility duration and the women's age, but had no significant differences. In the first four cycles, the cycle pregnancy rates were 24.03, 24.94, 24.69 and 25.00% (P > 0.05), and the cumulative pregnancy rates were 24.03, 39.53, 45.74 and 46.51%, with significant differences between the first cycle and the other three (P < 0.01).

CONCLUSIONOvulation induction is superior to natural cycle in AID for older women. IVF/ICSI can be resorted to only after AID has failed three or four times.

Adult ; Azoospermia ; therapy ; Female ; Humans ; Insemination, Artificial, Heterologous ; Male ; Ovulation Induction ; Pregnancy ; Pregnancy Rate ; Retrospective Studies

This paper summarized 120 cases of intraceteral insemination IUI during 3 years. The IUI found the encouraging results that 6 infertile cases due to both wives and husbands among 120 cases of infertility (5%). All 6 cases must be received the ovulation stimulation. 4/6 cases implemented with the cryo- preservation sperms.
Insemination, Artificial ; diagnosis ; therapeutics

OBJECTIVETo investigate the factors influencing the pregnancy outcomes of artificial insemination with donor sperm (AID), improve the pregnancy rate, and evaluate the safety of the offspring.

METHODSWe retrospectively analyzed 7,761 cycles of AID for 5,109 infertile couples performed between July 1, 2005 and June 30, 2013 in the Center of Reproductive Medicine of Shenyang No 204 Hospital, the outcomes of pregnancy, and the incidence of birth defects.

RESULTSTotally, 2 252 clinical pregnancies were achieved by AID, in which the pregnancy rate per cycle was 29. 02% and the cumulative pregnancy rate was 44. 08%. The clinical pregnancy rate was remarkably higher in the females of ≤ 35 years than in those of > 35 years old (30.31% vs 20.18%, P < 0.01), in the women with < 5-year infertility than in those with > 5-year infertility (30.83% vs 28.16%, P < 0.01), and in the patients of the ovarian stimulation group than in those of the natural cycle group (33.22% vs 28.68%, P < 0.01) The clinical pregnancy rate was the highest in the first treatment cycle (29.87%), with statistically significant difference from the fourth cycle (23.61%) (P < 0.05), but not between the other cycles (P > 0.05). There were 28 cases of birth defects in the offspring (1.40%), including 6 cases (21.43%) involving the cardiovascular system, 4 (14.29%) involving the musculoskeletal system, 3 (10.71%) involving the urogenital system, 3 (10.71%) involving the central nervous system, 2 cases (7.14%) of cleft lip and palate, 2 (7.14%) involving the respiratory system, 2 (7.14%) involving the gastrointestinal digestive system, and other anomalies.

CONCLUSIONFemale age, infertility duration, and ovarian stimulation treatment are important factors influencing the clinical pregnancy rate of AID. Artificial insemination with cryopreserved donor sperm does not increase the incidence of birth defects, which is considered as a relatively safe technique of assisted reproduction.

Adult ; Cryopreservation ; Female ; Humans ; Infertility ; Insemination, Artificial, Heterologous ; methods ; Male ; Maternal Age ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Semen Preservation ; methods ; Spermatozoa ; Time Factors

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

To determine the prognostic factors such as age, diagnosis, number of cycle attempts and semen parameters on the pregnancy rate of controlled ovarian hyperstimulation (COH) /intrauterine insemination (IUI). Three hundred and seventeen women who underwent 507 consecutive COH/IUI cycles were recruited from 1st January 2002 to 31st December 2005 inclusively. This retrospective study was done in University Malaya Medical Centre, a tertiary care academic centre. The main outcome measure was pregnancy rate according to age, infertility diagnosis, duration of infertility, semen parameters, and the number of treatment cycles. The overall pregnancy rates were 16.9% per cycle and 25.9% per couple. Pregnancy rates decreased with advancing maternal age. Pregnancy rate was also significantly lower in patient with postwash total motile sperm count (TMSC) < or = 20 million/ml compared to those with TMSC >20 million/ml. The cumulative pregnancy rates varied greatly by diagnosis from 16% for patients with male factor infertility to 60% for patients with ovulatory disorder. Pregnancies among patients with male infertility, tubal factors infertility and endometriosis were achieved during the first three cycles. There is a clear age-related decline in fecundity associated with COH/IUI treatment. Women of > 40 years old, couple with postwash TMSC < or = 20 million/ml, severe endometriosis and tubal factors have a particularly poor prognosis.
Pregnancy ; Infertility ; Intrauterine artificial insemination ; /mL ; Diagnostic

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 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