Intrauterine insemination (IUI) outcomes in cases performed by nurses as compared with cases performed by physicians

Klein, J.; Kuleta, D.

doi:10.1016/j.fertnstert.2007.07.052

Cited by 6 publications

(5 citation statements)

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“…The IUI technique is widely used to treat both male and female infertility disorders (Keck at el., 1997) such as severe hypospadias, retrograde ejaculation, impotence, vaginismus, poor post-coital tests and immunological infertility (Ombelet et al, 2003). As comparable pregnancy rates have been reported when the IUI procedures were carried out by physicians and nurses, in some busy centres, IUI procedure is now nurse-led (Klein et al, 2007). Success of any IUI program is influenced by correct, semen analysis parameters, This review will discuss how recent advances in laboratory techniques have evolved to influence the treatment protocols and the pregnancy rates in IUI.…”

Section: Introductionmentioning

confidence: 92%

Intrauterine Insemination with Special Reference to Density Gradient Centrifugation

Mehta

2012

Journal of Reproductive and Stem Cell Biotechnology

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Since Intra-uterine insemination IUI requires the isolation of motile spermatozoaatozoa, advances in andrology research has helped understand the physiology of male germ cell and allowed development of better and more sophisticated techniques to separate functional spermatozoaatozoa from those that are immotile, have poor morphology or are not capable to fertilize oocytes. When compared with other techniques, Density Gradients Centrifugation (DGC) technique allows maximum yield of motile spermatozoa. Several density media like IxaPrep, Nycodenz, SilSelect, PureSpermatozoa and Isolate have been developed to replace Percoll which, was banned in 1996 due to risk of contamination with endotoxins. Semen analysis, according to the revised, WHO (2010) criteria should be carried out prior to processing the sample. Although sophisticated testing—such as DNA fragmentation analysis, oxidative stress analysis and spermatozoa evaluation for genomic, proteomic and metabolic factor are in research phase, it is more than likely that in future these will help in assessing the suitability of the sample in certain cases of male factor or unexplained infertility. The isolation of functional spermatozoaatozoa from highly viscous ejaculates is a challenge that can be performed enzymatically to liquefy the ejaculate. Special care should be taken when processing HIV, Hep B and Hep C, positive samples. Prior to insemination, the processed sample should be tested to ensure the absence of HIV, Hep B and Hep C. There is no agreement between Andrologists as to what should be the minimum motile count for IUI to be successful. Pregnancies have been reported with counts in range of 1 – 10 million motile spermatozoas. Morphology of the processed sample has limited influence on the final outcome. Finally, single insemination 40 h after the hCG injection should be performed using a soft catheter. Normally, 2nd insemination 24 hrs later is only indicated when the follicle has not ruptured at 40 h post hCG injection.

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Section: Introductionmentioning

confidence: 92%

Intrauterine Insemination with Special Reference to Density Gradient Centrifugation

Mehta

2012

Journal of Reproductive and Stem Cell Biotechnology

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“…Perhaps a more significant contributor to the success of the IUI is the amount of training the provider has invested into the procedure itself, as suggested by previous studies that found higher pregnancy rates following embryo transfer and IUI with more experienced physician providers. 21,22 Further investigation of success rates stratified by number of procedures performed would help answer that question.…”

Section: Commentmentioning

confidence: 99%

“…21,22 One parameter that has not been well studied is the training level of the medical professional performing IUI procedures. Attending and fellow physicians have traditionally performed the majority of these procedures, with nurse practitioners and registered nurses (RNs) performing an increasing number of IUI procedures in recent years as the use of IVF has grown.…”

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confidence: 99%

Outcomes after intrauterine insemination are independent of provider type

Goldman

Batsis

Hacker

et al. 2014

American Journal of Obstetrics and Gynecology

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OBJECTIVE We sought to determine whether the success of intrauterine insemination (IUI) varies based on the type of health care provider performing the procedure. STUDY DESIGN This was a retrospective cohort study set at an infertility clinic at an academic institution. The patients who comprised this study were 1575 women who underwent 3475 IUI cycles from late 2003 through early 2012. Cycles were stratified into 3 groups according to the type of provider who performed the procedure: attending physician, fellow physician, or registered nurse (RN). The primary outcome was live birth. Additional outcomes of interest included positive pregnancy test and clinical pregnancy. Repeated measures log binomial regression was used to estimate the risk ratios (RR) and 95% confidence intervals (CI) for the outcomes and to evaluate the effect of potential confounders. All tests were 2-sided, and P values < .05 were considered statistically significant. RESULTS Of the 3475 IUI cycles, 2030 (58.4%) were gonadotropin stimulated, 929 (26.7%) were clomiphene citrate stimulated, and 516 (14.9%) were natural. The incidences of clinical pregnancy and live birth among all cycles were 11.8% and 8.8%, respectively. After adjusting for female age, male partner age, and cycle type, the incidence of live birth was similar for RNs compared with attending physicians (RR, 0.80; 95% CI, 0.58–1.1) and fellow physicians compared with attending physicians (RR, 0.84; 95% CI, 0.58–1.2). Similar results were seen for positive pregnancy test and clinical pregnancy. CONCLUSION There was no significant difference in live birth following IUI cycles in which the procedure was performed by a fellow physician or RN compared with an attending physician.

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“…Factors that may influence IUI outcome include the use of ovulation induction agents, semen analysis parameters, techniques used for sperm preparation and the timing and number of inseminations (Klein et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Intra Uterine Insemination in the Treatment of Infertility

Yaaqoub¹

2011

American Medical Journal

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Problem statement:To assess efficacy of IUI in treatment of infertility. Tikrit teaching hospital. Approach: 42 infertile couple underwent standard evaluation for infertility, woman given medication to stimulate development of mature follicles, washed semen specimen placed in uterine cavity using sterile flexible catheter, coincide with ovulation time. Results: Of 42 infertile couples pregnancy occur in 26(61.9%), (19.1%) in primary and (42.9%) in secondary infertility, (21.3%) of them was male infertility and (40.6%) of unexplained infertility. Pregnancy was less with prolong duration of infertility (35.7%) with 3-5 years, (21.3%) with 5-7 years and (4.8%) with 8 and more years of infertility. Conclusion: IUI is less expensive, less invasive and effective in treatment of couples with unexplained or male infertility.

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Intrauterine insemination (IUI) outcomes in cases performed by nurses as compared with cases performed by physicians

Cited by 6 publications

References 0 publications

Intrauterine Insemination with Special Reference to Density Gradient Centrifugation

Intrauterine Insemination with Special Reference to Density Gradient Centrifugation

Outcomes after intrauterine insemination are independent of provider type

Efficacy of Intra Uterine Insemination in the Treatment of Infertility

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