Factors Influencing the Pregnancy Outcome of Intrauterine Insemination and Follow-Up Treatment

Yao, Bing; Chen, Li; Huang, Xuan; Sun, Qin; Tang, Xu na; Li, Meiling; Zhou, Cheng; Cheng, Xi

doi:10.4103/jhrs.jhrs_130_22

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…29 Studies have shown that endometrial thickness was positively correlated with pregnancy rate after IUI. 16,[30][31][32] Li et al found that the increase of endometrial thickness can significantly improve the clinical pregnancy rate after IUI. 33 In addition, study has shown that endometrial thickness has no predictive value for IUI outcomes.…”

Section: Discussionmentioning

confidence: 99%

Low Estradiol Level and Endometrial Thickness on the Day of Endometrial Transformation Influence Clinical Pregnancy After Intrauterine Insemination

Tang,

Yi,

Chen

et al. 2024

IJGM

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The causes of pregnancy failure after intrauterine insemination (IUI) are controversial. The purpose of this study was to investigate the influencing factors on clinical pregnancy after IUI. Methods: This study retrospectively analyzed 1464 cycles of IUI performed at the Meizhou People's Hospital between March 2014 and June 2023. The χ 2 test and logistic regression analysis was applied to assess the associations between the some factors (maternal age, paternal age, cycle type (natural cycle or ovulation induction cycle), hormone level on the day of endometrial transformation (estradiol (E 2 ), luteinizing hormone (LH), and progesterone (P)), endometrial thickness on the day of endometrial transformation, and forward motile sperm concentration after treatment) and pregnancy failure. Results: Among the 1464 IUI cycles in this study, 268 cycles of assisted reproduction resulted in clinical pregnancy, with a clinical pregnancy rate of 18.3%. During the cycles with clinical pregnancy, there were 25 (12.9%) preterm births and 169 (87.1%) full-term births. The E 2 level on the day of endometrial transformation in clinical pregnancy group was higher than that in the pregnancy failure group (658.79±656.02 vs 561.21±558.83 pg/mL)(P=0.025). The clinical pregnancy group had a higher percentage of endometrial thickness between 8 and 13mm on the day of endometrial transformation than the pregnancy failure group (83.2% vs 75.0%) (P=0.002). The results of regressions analysis showed that low E 2 level on the day of endometrial transformation (<238.3 pg/mL vs ≥238.3 pg/mL: OR 1.493, 95% CI: 1.086-2.052, P=0.014), and endometrial thickness <8mm on the day of endometrial transformation (<8mm vs 8-13mm: OR 1.886, 95% CI: 1.284-2.771, P=0.001) may increase risk of pregnancy failure performed IUI. Conclusion: Low estradiol level, and endometrial thickness on the day of endometrial transformation may increase risk of pregnancy failure performed intrauterine insemination.

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Section: Discussionmentioning

confidence: 99%

Low Estradiol Level and Endometrial Thickness on the Day of Endometrial Transformation Influence Clinical Pregnancy After Intrauterine Insemination

Tang,

Yi,

Chen

et al. 2024

IJGM

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“…20 However, we should note that the sperm motility in the original semen findings is more sensitive to the success of IUI. Although some reports have indicated that pre‐wash semen findings are not related to IUI outcomes, 11 , 21 others have suggested the importance of initial pre‐wash sperm motility in successful IUI. 22 …”

Section: Discussionmentioning

confidence: 99%

“…compared factors influencing the outcomes of IUI between the pregnant group and the non‐pregnant group in order to elucidate any correlations and reported statistically significant differences in female anti‐mullerian hormone, endometrial thickness, and duration of ovarian stimulation. 11 …”

Section: Introductionmentioning

confidence: 99%

Impact of current and previous sperm findings on outcomes of intrauterine insemination

Taniguchi,

Kanasaki,

Oride

et al. 2024

Reprod Medicine & Biology

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PurposeTo examine the association between semen characteristics and outcomes of intrauterine insemination (IUI).MethodsThis retrospective analysis examined 1380 IUI procedures involving 421 couples. The association of clinical pregnancy with pre‐ and post‐wash sperm characteristics was assessed.ResultsPre‐ and post‐wash sperm characteristics did not differ between IUI cycles that resulted in pregnancy and those that did not. When the motility of pre‐wash sperm was below the normal range (<42%) established by the World Health Organization (WHO), the pregnancy rate was significantly lower. In the IUI cycles when post‐wash sperm motility was below the WHO standard, pregnancy was not achieved. The frequency of improvement in post‐wash sperm motility in repeated IUI cycles appeared to correlate with the success of future IUI cycles. At the fourth IUI cycle, pregnancy was not achieved unless the post‐wash sperm motility was normal in at least two of three attempts. When post‐wash sperm concentration was below the normal range, the woman's age did not affect the IUI outcomes.ConclusionsSperm motility above the lower limit of the WHO criteria in post‐wash semen samples is an important factor in IUI outcomes.

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Effect of follicle size on pregnancy outcomes in patients undergoing first letrozole-intrauterine insemination

Ling,

Xia,

Jin

et al. 2024

Eur J Med Res

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Background Letrozole has been proven to be an effective method for inducing ovulation. However, little attention has been paid to whether the lead follicle size will affect the success rate of intrauterine insemination (IUI) with ovulation induction with alone letrozole. Therefore, we hope to investigate the effect of dominant follicle size on pregnancy outcomes on human chorionic gonadotropin (hCG) day of the first letrozole-IUI. Methods A retrospective cohort study design was employed. We included patients with anovulation or unexplained infertility undergoing first IUI treatment with letrozole for ovarian stimulation. According to the dominant follicle size measured on the day of hCG trigger, patients were divided into six groups (≤ 18 mm, 18.1–19.0 mm, 19.1–20.0 mm, 20.1–21.0 mm, 21.1–22.0 mm, > 22 mm). Logistic models were used for estimating the odds ratios (ORs) with their 95% confidence interval (CIs) for achieving a clinical pregnancy or a live birth. A restricted cubic spline was drawn to explore the nonlinear relationship between follicle size and IUI outcomes. Results A total of 763 patients underwent first letrozole-IUI cycles in our study. Fisher exact test showed significant differences among the six follicle-size groups in the rates of pregnancy, clinical pregnancy and live birth (P < 0.05 in each group). After adjusting the potential confounding factors, compared with the follicles ≤ 18 mm in diameter group, 19.1–20.0 mm, 20.1–21.0 mm groups were 2.3 or 2.56 times more likely to get live birth [adjusted OR = 2.34, 95%CI (1.25–4.39); adjusted OR = 2.56, 95% CI (1.30–5.06)]. A restricted cubic spline showed an inverted U-shaped relationship between the size of dominant follicles and pregnancy rate, clinical pregnancy rate, and live birth rate, and the optimal follicle size range on the day of hCG trigger was 19.1–21.0 mm. When the E2 level on the day of hCG trigger was low than 200 pg/mL, the clinical pregnancy rates of 19.1–20.0 mm, 20.1–21.0 mm groups were still the highest. Conclusions The optimal dominant follicle size was between 19.1 and 21.0 mm in hCG-triggered letrozole-IUI cycles. Either too large or too small follicles may lead to a decrease in pregnancy rate. Using follicle size as a predicator of pregnancy outcomes is more meaningful when estrogen on the day of hCG trigger is less than 200 pg/ml.

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Factors Influencing the Pregnancy Outcome of Intrauterine Insemination and Follow-Up Treatment

Cited by 3 publications

References 28 publications

Low Estradiol Level and Endometrial Thickness on the Day of Endometrial Transformation Influence Clinical Pregnancy After Intrauterine Insemination

Low Estradiol Level and Endometrial Thickness on the Day of Endometrial Transformation Influence Clinical Pregnancy After Intrauterine Insemination

Impact of current and previous sperm findings on outcomes of intrauterine insemination

Effect of follicle size on pregnancy outcomes in patients undergoing first letrozole-intrauterine insemination

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