Abstract
ObjectiveThis study aimed to evaluate the clinical pregnancy rate of intrauterine insemination cycles in relation to patient age, cause of infertility, ovulation induction method, number of mature follicles and sperm with progressive motility.MethodsThis retrospective observational study included 237 intrauterine insemination cycles performed from 2011 to 2015 at the Assisted Reproduction Service of the Hospital das Clínicas of the Ribeirão Preto Medical School, University of São Paulo. Student's t-test was used to compare quantitative variables and the chi-square test was used to compare qualitative variables.ResultsPatient age was inversely and significantly correlated with pregnancy rates (p=0.001) (Pregnant women = 32.56±5.64 years, non-pregnant women = 36.64±5.03 years). Cause of infertility, ovulation induction method, number of mature follicles and sperm with progressive motility were not associated with pregnancy rates. The overall clinical pregnancy rate was 7.59%. In the subgroup of patients (n=102 cycles) considered ideal for intrauterine insemination (age ≤35 years, unexplained infertility, ovarian factor infertility or minimal endometriosis, and a partner with sperm count ≥2.5×106 retrieved on the day of insemination) the pregnancy rate was 12.74%.ConclusionIn the studied group, female patient age was the only variable significantly correlated with intrauterine insemination success rates.
Highlights
Infertility is a public health concern that drives many couples to seek assisted reproductive technology (ART) therapies
Several prognostic factors linked to the outcome of intrauterine insemination (IUI) have been identified and related to type of ovarian stimulation and couple characteristics such as female patient age, type and duration of infertility, number of mature follicles recruited, endometrial thickness, number of sperm with progressive motility, sperm morphology, and number of sperm used in insemination (Dinelli et al, 2014; Fauque et al, 2014; Ghaffari et al, 2015)
Since 1992, the Assisted Reproduction Service of the Hospital das Clínicas of the Ribeirão Preto Medical School of the University of São Paulo (HC-FMRP/USP) has offered ART and IUI with patients paying only for the medication used in the procedures
Summary
Infertility is a public health concern that drives many couples to seek assisted reproductive technology (ART) therapies. Due to the high cost of in vitro fertilization (IVF), less invasive and more affordable procedures such as intrauterine insemination (IUI) have become more popular (Ashrafi et al, 2013; Fauque et al, 2014). IUI is indicated in cases of unexplained infertility, male subfertility, unilateral tubal blockage, cervical or ovulatory dysfunction, and mild or minimal endometriosis (Azantee et al, 2011; Fauque et al, 2014). Despite the improvements in semen preparation and controlled ovarian stimulation techniques, the success rates reported for IUI are lower than the rates reported for other ART procedures (Ghaffari et al, 2015). Global pregnancy rates as high as 30% have been reported in some studies on IUI, results vary depending
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