ABSTRACT
To examine whether pregnancy rate [PR] of intrauterine insemination [IUI] is related to certain demographic factors, such as age and body mass index [BMI], along with number of IUI cycles performed, a set of infertile Saudi women. During this prospective study [a 24-month period], 301 Saudi women with infertility underwent IUI in our infertility clinic. We investigated whether PR is correlated with patient age and BMI, and the number of IUI trials, in order to determine if they could be used as prognosticators of pregnancy success. The highest PR was 14.89% for ages 19-25 and the lowest PR was 4.16% for ages 41-45, indicating no statistically significant difference among PR in all age groups [p value of 0.225]. Also, in terms of BMI, the highest PR was 13.04% for BMI >/= 35 and the lowest was 7.84% for BMI of <25 to 18.5, indicating no significant difference among different BMI groups [p value of 0.788]. One-cycle treatment, as expected, was more successful [PR=12.84%] than 2-cycle treatment [PR=5.75%], however, 3-5-cycles treatment still showed encouraging results [PR=17.24%]; but the difference did not reach statistical significance [p value=0.167]. PR after IUI treatment remained approximately 10% from 19 to 40 years of age and declined after 40. Although no significant difference was observed among different age groups, earlier treatment is still recommended. There was a positive but not statistically significant correlation between PR and patient's BMI indicating that BMI is not a determining factor. There was also no correlation between PR and number of IUI trials. Patients can thus try as many times as they want before moving on to in vitro fertilization [IVF] treatment
Subject(s)
Humans , Female , Uterus , Age Factors , Body Mass Index , Pregnancy Rate , Prospective Studies , InfertilityABSTRACT
Intrauterine Insemination [IUI] remains the first thought of infertility treatment. To compare the stimulation effects and Pregnancy rate [PR] outcomes of two ovulation induction [OI] medications, human-derived menopausal gonadotrophins [hMGH], Merional [MER], and recombinant follicular stimulating hormone [rFSH], Puregon [PUR], in a cohort of Saudi infertile patients, for better predictability of treatment results. During a 24-month period, 296 women underwent IUI single treatments. PR's were correlated with the type of stimulation medication that were prospectively and randomly assigned to each patient, and with the number and size of maturing follicles detected on the hCG injection day. MER and PUR needed comparable number of days [9.26 +/- 4.74 and 9.73 +/- 6.27 respectively] before follicles were ready for IUI, although the average amount used from MER, 1199.90 IU, was about double that was used from PUR, 621.08 IU. The overall PR in case of PUR however was nearly double that of MER, 13.28% and 7.14% respectively. The best PR, 16.22%, occurred when the follicles matured within 12-13 days. Three follicles of at least 15-mm diameter on the hCG day had better PR's than one or two, however when the follicles' diameters were at least 18-mm, PR was significantly higher, [p=0.013]. MER and PUR had comparable stimulation effects; however PUR had noticeably higher PR. The best PR occurred when the follicles matured within 12-13 days. PR in case of three maturing follicles on the hCG day was better than only one or two, and significantly better when their diameters were at least 18 mm
ABSTRACT
The study meant to define the prognostic factors that help in prescribing intrauterine insemination [IUI] for infertility treatment which remains an area of continuous improvements. The diagnostic indications of a cohort of IUI-treated patients and their corresponding pregnancy rates [PRs] were randomly and prospectively studied among Saudi cohort of 303 patients for a period of 20 months. The indications of IUI cases were statistically analyzed for those eligible patients over a period of twenty months [January 2010 till August 2011], and the PR that corresponded to each group was investigated as well. P-value less than 0.05 was considered significant. The highest PR, 18.87%, of the polycystic ovarian syndrome [PCOS]-only diagnosed patients, was significantly higher than the average PR of all other indications combined, 7.22%, [p=0.011, compared to all other groups combined]. The second highest PR, 14.0%, of the tubal factor [TF]-only indication, was double the PR average of all other indications combined, though it did not reach significance. However, PCOS and TF accompanied by other indications caused the PR to drop to 5.88% and 5.56%, respectively. However, a group of some hormonal-imbalance based indications had the least PR [0.0% to 2.70%]. Those indications were elevated serum FSH, hyperprolactinemia, hypogonadotrophy, hypothyroidism and endometriosis. The rest of the indications had an average PR [8.33% to 11.11%]. There is a reasonable chance of conception after IUI treatment for female factor infertility except in cases with sever hormonal imbalance. The PCOS cases having the best success chances