Stimulated intrauterine insemination in women with unilateral tubal occlusion

Abstract

ObjectiveTo investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion.MethodsSuperovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle.ResultsThe pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant.ConclusionStimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.

Outcome of Intra Uterine Insemination in Sahara International Fertility Centre Pokhara, Nepal

“…15,16 But in one of the study group with 133 patient treated for the unilateral tubal block with ovarian stimulation diagnosed by HSG during 2005-2011 the pregnancy rate was 12.5%. 17 The higher rate of success in our study may be due to our study not classifying the cases as proximal or distal block.…”

The effect of unilateral tubal block diagnosed by hysterosalpingogram on clinical pregnancy rate in intrauterine insemination cycles: systematic review and meta‐analysis

“…Among women who ultimately do pursue COH‐IUI, our subgroup analysis suggests that the specific location of an obstruction along the tube may also influence the odds of successful pregnancy. Farhi et al first noted this apparent discrepancy in pregnancy outcomes, and several studies have since noted similar trends, whereas others noted differences but were inadequately powered to detect a significant difference . Conversely, Eschliman et al demonstrated improved CPR in cases of mid‐distal occlusion (38%) compared with distal (23%) and proximal (17%) occlusion, although differences were not significantly different as only 24 cases of stands for unilateral tubal occlusion (UTO) were included.…”

“…Subgroup analyses were also performed within the tubal block versus control comparison using different numbers of total cycles: specifically, we compared pregnancy outcomes after up to one, up to three, and up to six cumulative IUI cycles. Importantly, it should be noted that Yi et al did not specify the number of cycles, but it was noted to be more than one as the total number of cycles reported exceeded the total number of patients enrolled in the study.…”

“…In a retrospective case–control study, Farhi et al demonstrated that similar cumulative pregnancy outcomes can be achieved through controlled ovarian hyperstimulation and intrauterine insemination (COH‐IUI) in cases of proximal tubal occlusion diagnosed by HSG, compared with patients with unexplained infertility and bilateral patent tubes; however, distal tubal occlusion yielded lower cumulative pregnancy outcomes after three consecutive IUI cycles. Conversely, several more recent studies demonstrated significantly lower clinical pregnancy and live birth rates in cases of unilateral tubal occlusion, regardless of location . Hence, a consensus has yet to be reached on this topic, and the purpose of this meta‐analysis is to evaluate whether pregnancy outcomes after COH‐IUI among infertile women with unilateral tubal block diagnosed by HSG are different compared with women with bilateral patent tubes and unexplained infertility.…”

The outcomes of controlled ovarian hyperstimulation/intrauterine insemination in patients with unilateral tubal occlusion on hysterosalpingograph

“…The authors stated that there was no significant difference between the two groups in terms of cumulative pregnancy rates. Yi et al ( 12 ) evaluated the outcomes of COH/IUI treatment among thirty-seven infertile women (52 cycles) with unilateral tubal occlusion compared with a control group that included patients with unexplained infertility. The pregnancy rate per cycle was 17.3% in patients with unilateral tubal occlusion and 16.5% in the control group without statistical significance.…”