Prognosis factors of pregnancy after intrauterine insemination with the husband's sperm: Conclusions of an analysis of 2,019 cycles

摘要

Objective To identify the prognostic factors for pregnancy after intrauterine insemination with the husband's sperm (IUI-H). Design Retrospective study. Setting A single university medical center. Patient(s) 851 couples, for 2,019 IUI-H cycles. Intervention(s) After controlled ovarian stimulation, IUI-H performed 36 hours after ovulation triggering or 24 hours after a spontaneous luteinizing hormone (LH) surge. Main Outcome Measure(s) Clinical pregnancy rate per cycle (PR) and delivery rate per cycle (DR). Result(s) The overall PR was 14.8% and DR 10.8%. Higher PR and DR were observed for patients presenting with ovulation disorders (particularly polycystic ovary syndrome) or with male infertility. Secondary infertility in the woman appeared to be a positive prognostic factor as did a basal follicle-stimulating hormone (FSH) level ≤7 IU/L and ovulation triggering over spontaneous LH rise. The other parameters influencing the results were the women's age, the number of mature follicles obtained (≥2), the endometrial thickness (10-11 mm), and the number of progressive motile spermatozoa inseminated (1 million). Conclusion(s) In women aged ≤38 years, IUI-H should be considered as an option, particularly in cases of female infertility from ovulation disorders, in cases of a normal ovarian reserve, in cases of secondary infertility, or when ≥1 million progressive sperm are inseminated. Bifollicular stimulation is required. In other cases, in vitro fertilization should be discussed as the first-line treatment.