Factors affecting pregnancy rate of artificial insemination in patients with unexplained infertility

Abstract

Objective To explore the factors that may affect the clinical outcomes of intrauterine insemination (IUI) in patients with unexplained infertility (UI). Methods The clinical data of 352 cycles of 142 UI patients undergoing IUI from January, 2011 to November, 2017 at our center were analyzed retrospectively. The patients were divided into a primary infertility group (P) and a secondary infertility group (S) according to the characteristics of infertility. The clinical pregnancy rate, biochemical pregnancy rate, multiple pregnancy rate, miscarriage rate, and ectopic pregnancy rate were compared between these two groups. According to the medication protocols, the patients were divided into group 1, taking natural protocol, group 2, taking clomiphene and human urinary gonadotropin (HMG), and group 3, taking HMG only; and the above pregnancy outcomes were compared among the 3 groups. Results The spontaneous pregnancy loss in group P was significantly higher than that in group S (P 0.05). The pregnancy rate and the number of over 16 mm folliculus were higher in the ovulation induction than in the natural protocol (P<0.05). The dosage of Gn was higher in group 3 than in group 2 and than in group 1, with statistical differences (P<0.05). After the treatment, the ratio of forward mobile sperm was higher in group 2 than in group 3 and than in group 1, with statistical differences between group 1 and group 2 and between group 2 and group 3 (P<0.05). Conclusions The miscarriage rate of UI patients with primary infertility(PI) is higher than that of secondary infertility(SI). An ovulation-promoting regimen is recommended, but as the number of mature follicles increases(n>3), the clinical pregnancy rate does not increase. As the women's age increases, the clinical pregnancy rate drops. Key words: Unexplained infertility; Artificial insemination; Pregnancy; Miscarriage