Evaluating the efficacy of ovulation stimulation with intrauterine insemination in women with diminished ovarian reserve compared to women with normal ovarian reserve

Abstract

Objective To assess the efficacy of ovulation induction and intrauterine insemination (IUI) in couples with diminished ovarian reserve (DOR). Methods Women aged 20–39 years and men younger than 50 years were included. Four “ovarian reserve groups” were created according to anti‐Müllerian hormone (AMH) and the partner's age. Gestational sac finding on ultrasound examination was the primary outcome measure. Results The study was carried out on a total of 770 cycles of 362 women in an infertility cohort that consisted of 75 women with DOR treated by 153 cycles and 287 women without DOR treated by 617 cycles. The pregnancy rate was similar in the four ovarian reserve groups in terms of first, second, third plus fourth, and total attempts of IUI cycles. Moreover, the pregnancy rate, miscarriage rate, and multiple pregnancy rate were similar. We found no difference in the cumulative pregnancy rate among the groups after four IUI cycles. Multivariate logistic regression analysis of the entire cohort revealed that infertility duration, post‐wash sperm count, and follicle number greater than 11 mm on the day of human chorionic gonadotropin trigger were independent predictors of pregnancy (P < 0.001). Neither age nor AMH predicted pregnancy after ovulation stimulation and IUI. Conclusions Ovulation stimulation and IUI are equally effective in women with DOR and in women with normal ovarian reserve in terms of pregnancy rate, multiple pregnancy rate, and miscarriage rate per IUI cycle or cumulative pregnancy rate after four cycles of IUI.

Pregnancy outcomes of intrauterine insemination in young patients with diminished ovarian reserve: a multicenter cohort study

“…Kaleli et al [ 11 ] compared pregnancy outcomes in DOR and NOR patients according to the Poseidon criteria, which combine age and AMH levels. They found no difference in clinical pregnancy rates among the IUI groups.…”

“…There were no significant differences in the HCG-positive, biochemical loss, clinical pregnancy, first pregnancy, and live birth rates between the two groups [ 10 ]. In another study, which grouped patients according to the Poseidon criteria (75 DOR patients with 153 cycles and 287 NOR patients with 617 cycles), pregnancy, miscarriage, and multiple pregnancy rates were similar among the groups [ 11 ]. A study in Chinese Taipei obtained the opposite result; their study concluded that AMH levels had a significant independent effect on pregnancy outcomes, and low AMH levels were associated with a lower chance of clinical pregnancy [ 12 ].…”

Efficacy of Kirin pill plus vitamin CE and coenzyme Q10 in the treatment of ovarian reserve hypofunction

“…Ovary is a sex organ that produces and expels ova, and secretes steroid hormones. The ova are stored in the ovary, and their quality determines the reserve function of the ovary [1]. Diminished ovarian reserve (DOR) is a decrease in the quality of oocytes in the ovary and their ability to produce eggs, which mainly manifests as menstrual cycle disorders, reduced menstrual volume, and decreased fertility, thereby compromising women's fertility and quality of life [2].…”