The effect of ovarian stimulation on the outcome of intrauterine insemination

Schorsch, Martin; Steetskamp, J; Hahn, Thomas von; Heidner, Kristina; Seufert, R.; Skala, Christine

doi:10.1007/s00404-013-2952-3

Cited by 16 publications

(16 citation statements)

References 12 publications

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“…Our study is consistent with earlier reports with regard to the lack of benefit of CC, LE or HMG alone in ovulatory women undergoing IUI. However, we showed that LE combined with HMG increased the pregnancy and live birth rates in these women.…”

Section: Discussionsupporting

confidence: 93%

The impact of ovarian stimulation on the outcome of intrauterine insemination treatment: an analysis of 8893 cycles

Liu

Wang

et al. 2016

BJOG

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Objective To evaluate the impact of ovarian stimulation on the outcome of intrauterine insemination (IUI). Design Retrospective analysis. Setting A single university‐based centre. Population A total of 5109 couples with 8893 cycles. Methods The outcome of IUI with different protocols for ovarian stimulation was examined. Main outcome measures The live birth rate (LBR), twin pregnancy rate and ovarian hyperstimulation syndrome (OHSS). Results In ovulatory women without ovarian stimulation, the LBR was 7.6%. Stimulation with clomifene citrate (CC), letrozole (LE), human menopausal gonadotrophin (HMG), CC or LE combined with HMG achieved LBRs of 6.1, 5, 7.9, 8 and 12.2%, respectively. LE combined with HMG achieved a significantly improved LBR compared with no stimulation. HMG stimulation was associated with a higher rate of twins (7.4%) than no stimulation (0%, P < 0.01). In ovulatory women, the LBR appeared lower in CC and LE compared with no stimulation (P > 0.05). In anovulatory women, ovarian stimulation with CC, LE, HMG, CC or LE combined with HMG achieved LBRs of 11.3, 5.1, 11.8, 12.6 and 13.6%, respectively. No significant difference was observed. There were no triplet pregnancies or OHSS in stimulated cycles. Conclusions In ovulatory women, ovarian stimulation with LE combined with HMG achieved a significantly improved live birth rate. HMG stimulation resulted in a high risk for twins. Tweetable abstract In ovulatory women, ovarian stimulation with letrozole and HMG resulted in a significantly improved LBR.

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Section: Discussionsupporting

confidence: 93%

The impact of ovarian stimulation on the outcome of intrauterine insemination treatment: an analysis of 8893 cycles

Liu

Wang

et al. 2016

BJOG

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“…However, in the HHU and LIN studies, types of ovarian stimulation were distributed equally between the IUI and SRI groups (Table 2), whereas Muharib et al had not used ovarian stimulation at all [10]. Although ovarian stimulation is well known to improve IUI outcome [2, 21], its lack in some cases should not have influenced the main results of this meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

“…The probability of conceiving with this infertility treatment depends on several factors, including age, reason for subfertility or infertility, absence/presence and type of ovarian stimulation, as well as the timing of insemination [2]. According to a large retrospective cohort analysis from the Netherlands, covering more than 15,000 IUI-cycles, the mean pregnancy rate was 5.6% per cycle.…”

Section: Introductionmentioning

confidence: 99%

“…Many studies on IUI have dealt with strategies for improvement of pregnancy rates: the attention has focused on andrological factors, modification of controlled ovarian hyperstimulation (COH) protocols, and technique and timing of the IUI [2, 4, 5]. According to a recent Cochrane Database review, IUI with COH increases the live birth rate compared to IUI alone.…”

Section: Introductionmentioning

confidence: 99%

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The effect of slow release insemination on pregnancy rates: report of two randomized controlled pilot studies and meta-analysis

Marschalek

Franz

Gonen

et al. 2017

Arch Gynecol Obstet

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PurposeA modified application technique of intrauterine insemination (IUI) is slow release insemination (SRI), first described by Muharib et al. (Hum Reprod 7(2):227–229, 1992), who postulated higher pregnancy rates with a slow release of spermatozoa for 3 h.MethodsTo investigate this approach, two randomized controlled, cross-over pilot studies were performed from 2004 to 2006 in Israel and Germany to compare SRI with the standard bolus IUI. We aimed to present the results and perform a meta-analysis on available data for SRI. Univariate comparisons of pregnancy rates were performed using one-tailed z tests for method superiority. For meta-analysis, a fixed-effect Mantel–Haentzel weighted average of relative risk was performed.ResultsFifty treatment cycles (IUI: n = 25, SRI: n = 25) were performed in Germany, achieving four pregnancies (IUI: 4%, SRI: 12%, p > 0.05). Thirty-nine treatment cycles (IUI: n = 19, SRI: n = 20) were performed in Israel achieving six pregnancies (IUI: 10.5%, SRI: 20%; p > 0.05). Meta-analysis of all eligible studies for SRI (n = 3) revealed a combined relative risk for pregnancy after SRI of 2.64 (95% CI 1.04–6.74), p = 0.02).ConclusionsIn conclusion, these results lend support to the hypothesis that the pregnancy rate might be improved by SRI compared to the standard bolus technique.

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“…Furthermore, the use of a natural cycle involves a reduction of medication costs and the prevalence of multiple pregnancies is lower in comparison to stimulated cycles [63,64]. However gonadotropins stimulated cycles have higher pregnancy rates compared with natural cycles [65].…”

Section: Synchronizing Intrauterine Insemination With Ovulationmentioning

confidence: 99%

How to Perform the Best Intrauterine Insemination? A Review

Carranza¹,

Santamaría²

2015

Andrology (Los Angel)

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Intrauterine insemination is a treatment used in couples with mild/moderate male factor, when female partner has at least one tube patent. Numerous studies have attempted to determine for many years which parameters are limiting to ensure pregnancy with this technique of assisted reproduction. This review focuses on prognostic factors for a successful outcome, as semen quality, female etiology, synchronization with ovulation, assessment of follicle rupture, number of inseminations per cycle and influence of uterine contractions. We conclude with this review that intrauterine insemination is a less invasive and expensive option than others [IVF], with acceptable results when adequately indicated. We conclude with this review that intrauterine insemination can be performed when patient is less than 40 years old and there are at least 5 million of motile sperm to be inseminated. The abstinence interval of 3 days prior to produce the sperm sample is the optimal period and either one or two inseminations are valid, ideally performed in the frame time between 12 and 38 hours after ovulation induction. Also, follicle rupture and uterine contractions observed by ultrasound scan following intrauterine inseminations are favorable prognostic factors.

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The effect of ovarian stimulation on the outcome of intrauterine insemination

Abstract: To sum up, clomiphene stimulation showed to offer significantly lower pregnancy rates in comparison to the natural cycle, FSH stimulation and HMG stimulation in IUI treatment. While women younger than 40 seem not to profit from any ovarian stimulation, women over 40 do profit.

Cited by 16 publications

References 12 publications

The impact of ovarian stimulation on the outcome of intrauterine insemination treatment: an analysis of 8893 cycles

The impact of ovarian stimulation on the outcome of intrauterine insemination treatment: an analysis of 8893 cycles

The effect of slow release insemination on pregnancy rates: report of two randomized controlled pilot studies and meta-analysis

How to Perform the Best Intrauterine Insemination? A Review

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