Younger women with ovulation disorders and unexplained infertility predict a higher success rate in superovulation (SO) intrauterine insemination (IUI).
- Author:
	        		
		        		
		        		
			        		Veronique VIARDOT-FOUCAULT
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Bee Choo TAI
			        		
			        		;
		        		
		        		
		        		
			        		Ethiraj Balaji PRASATH
			        		
			        		;
		        		
		        		
		        		
			        		Matthew S K LAU
			        		
			        		;
		        		
		        		
		        		
			        		Jerry K Y CHAN
			        		
			        		;
		        		
		        		
		        		
			        		Seong Feei LOH
			        		
			        		
		        		
		        		
		        		
			        		
			        		Author Information
			        		
 - Publication Type:Journal Article
 - MeSH: Adult; Age Factors; Clomiphene; therapeutic use; Cohort Studies; Female; Fertility Agents, Female; therapeutic use; Humans; Infertility, Female; etiology; Insemination, Artificial; methods; Pregnancy; Pregnancy Rate; Prognosis; Retrospective Studies; Superovulation
 - From:Annals of the Academy of Medicine, Singapore 2014;43(4):225-231
 - CountrySingapore
 - Language:English
 - 
		        	Abstract:
			       	
			       		
				        
				        	
INTRODUCTIONSuperovulation-intrauterine insemination (SO-IUI) is the most common assisted reproductive technique (ART) in the world, with good evidence of efficacy and cost-effectiveness. However, parameters affecting its success have not been consistently reported. So in this study, we aim at determining the parameters influencing the success rate of SO-IUI.
MATERIALS AND METHODSWe conducted a retrospective cohort study of 797 SO-IUI cycles from 606 patients, performed between 2007 and 2009 in a single centre. These women received clomiphene citrate (CC), recombinant FSH (rFSH) or both.
RESULTSThere were 127 clinical pregnancies with a pregnancy rate (PR) of 15.9% (127/797) per treatment cycle. Factors associated with higher PR included maternal age <38 (P = 0.02), subfertility diagnoses of ovulatory disorders, unexplained infertility, sexual dysfunction and unilateral tubal obstruction (P = 0.02), an endometrial thickness ≥8 mm (P = 0.03), total number motile spermatozoa (TNMS) of ≥1 million (P = 0.03), and spermatozoa normal forms (NF) ≥4% (P <0.01) on bivariate analysis. When CC is used, the endometrial thickness is more likely to be suboptimal (<8 mm). All the above parameters remained significant except the subfertility diagnoses on multivariate analysis.
CONCLUSIONPatients' selection with women <38 years old and preferably with ovulation disorders and unexplained infertility is associated with the highest PR in SO-IUI. Cycle parameters such as the use of rFSH alone, with the avoidance of CC, TNMS ≥1 million and NF ≥4% is likely to result in the best outcomes and reduce the high order multiple pregnancy risk.
 
            