P-599 The use of serum test to detect the LH surge in ultrasound-monitored intrauterine insemination (IUI) significantly increases pregnancy rates.

Abstract

Abstract Study question Could a serum test to detect LH surge in ultrasound-monitored IUI cycle improve pregnancy rates? Summary answer Serum test to detect LH surges with ultrasound monitoring during IUI cycle significantly increased pregnancy rates. What is known already IUI is known as the first line of treatment for infertile couples and is usually administered with human chorionic gonadotropin (hCG) before ovulation with clomiphene citrate (CC) or/and human menopausal gonadotropin (hMG) to ovarian known to stimulate. One of the key factor for IUI is that insemination should be performed close to ovulation time, as there are many reports that sperm injection at the ovulation time has a high pregnancy rates. However, there are still few reports on the optimal timing of ovulation for performing IUI. Study design, size, duration The IUI performed from January 2016 through November 2022 (n = 3187) was included in this study. A total of 875 patients underwent the IUI by inferring LH surge with procedure with serum test, while 2312 patients underwent the procedure IUI without the serum test (control). Participants/materials, setting, methods In this study included 3187 IUI cycle were analyzed. Controlled ovarian hyperstimulation was conducted with CC (100 mg/day) and hMG. Patients were divided into two groups with serum test or not test (control). The serum test group was monitored LH surge by inferring LH peak during IUI cycle. When the sufficient follicular size and endometrial thickness had been reached, hCG was administrated and insemination was performed. Pregnancy rates were compared by Chi-squared test. Main results and the role of chance In each group, there were no significantly difference in age (34.4±3.7 vs. 34.7±3.7 years old) and endometrial thickness (8.8±2.2 vs. 8.9±2.2 mm) for IUI cycle condition. The serum test group was significantly higher clinical pregnancy rates compared to control group (19.0 vs. 15.7 % respectively) during IUI cycle (P < 0.05). In addition, patients were classified according to the history of at least one or more failed IUI cycle. The clinical pregnancy rates was significantly higher in the serum test group than control group (21.6 vs. 10.8 % respectively) who history of at least one or more failed IUI cycle (P < 0.001). Limitations, reasons for caution A limitation of this study has a too small size of the intervention group compared with the control group. Wider implications of the findings In our results, the serum test group had a significantly higher clinical pregnancy rates than the control group. Therefore, detecting a surge in LH with a serum test during the IUI cycle could predict the optimal timing of ovulation and thus increase the pregnancy rates. Trial registration number not applicable