Abstract
Objective: To evaluate the effect of human chorionic gonadotropin (hCG) trigger ovulation on pregnancy outcomes in natural IUI cycles with donor sperm.Methods: This retrospective cohort study included 5,610 first-natural IUI cycles with donor sperm in infertile couples during the period from January 2012 to December 2017. To control for other confounding factors, our analysis was restricted to normo-ovulatory women without tubal infertility. The main outcome measure was live birth rate; the secondary outcomes included rates of clinical pregnancy and miscarriage.Results: In the crude analysis, both the clinical pregnancy (27.40 vs. 22.73%; P = 0.001) and live birth rates (24.52 vs. 20.13%; P = 0.007) were significantly higher for the hCG group than for the spontaneous LH group. After adjustment for a number of confounding factors, the reproductive outcomes were still significantly worse for the spontaneous ovulatory group.Conclusions: Among women undergoing natural cycle IUI with donor sperm, hCG triggered ovulation for timing insemination offers beneficial impacts on both clinical pregnancy rates and live birth rates.
Highlights
Intrauterine insemination (IUI), a minimally invasive and low-cost procedure, is a first-line treatment for a broad range of indications in reproductive medicine [1, 2]
The current study examined a large cohort of women undergoing natural cycle IUI and aimed to assess the effect of humanHCG-Triggered Ovulation in IUI chorionic gonadotropin (hCG)-induced ovulation on pregnancy outcome of natural cycle IUI
A total of 5,610 patients who were treated with IUI from January 2012 until December 2017 were included in the study
Summary
Intrauterine insemination (IUI), a minimally invasive and low-cost procedure, is a first-line treatment for a broad range of indications in reproductive medicine [1, 2]. IUI involves timely scheduled insemination of sperm into the uterus, either in natural cycles, or following ovarian stimulation. Compared to stimulated IUI, natural cycle IUI is preferable for patients because of advantages including lower medication cost and reduced rates of multiple gestation [3]. It is known that the timing of insemination is one of the most impactful factors influencing the success rates of IUI [4, 5]. There are various methods for timing IUI, and administration of human. HCG-Triggered Ovulation in IUI chorionic gonadotropin (hCG) is widely accepted in clinical practice. Administration of hCG requires less endocrine monitoring, but its effect on endometrial receptivity has drawn extensive attention recently [6,7,8]
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