Study on the scheme of intrauterine insemination in patients with unexplained infertility / 中国医师进修杂志

ABSTRACT

Objective:To investigate the effect of different schemes of intrauterine insemination (IUI) on pregnancy outcome in patients with unexplained infertility.Methods:The clinical data of 393 cases (934 cycles) with unexplained infertility patients who underwent IUI from March 2016 to August 2018 in Dalian Maternal and Child Health Hospital were retrospectively analyzed. The patients were divided into natural cycle group (402 cycles) and promote ovulation cycle group (532 cycles). In promote ovulation cycle group, the patients were divided into clomiphene (CC) subgroup (124 cycles), letrozole (LE) subgroup (107 cycles), menotropins (HMG) subgroup (87 cycles), CC + HMG subgroup (103 cycles), LE + HMG subgroup (111 cycles). The pregnancy outcomes of each group were compared.Results:The clinical pregnancy rate and live birth rate in promote ovulation cycle group were significantly higher than those in natural cycle group 14.10% (75/532) vs. 9.20% (37/402) and 11.28% (60/532) vs. 7.21% (29/402), and there were statistical differences ( P<0.05). There were no statistical differences in abortion rate, ectopic pregnancy rate and twin pregnancy rate between 2 groups ( P<0.05). Ovarian hyperstimulation syndrome occurred in 7 cycles, all of which were in CC + HMG subgroup. The clinical pregnancy rate and live birth rate in LE subgroup, HMG subgroup, CC + HMG subgroup and LE + HMG subgroup were significantly higher than those in CC subgroup 11.21% (12/107), 13.79% (12/87), 16.50% (17/103), 21.62% (24/111) vs. 8.06% (10/124) and 7.48% (8/107), 11.49% (10/87), 13.59% (14/103) and 20.72% (23/111) vs. 4.03% (5/124), the abortion rate was significantly lower than that in CC subgroup 3/12, 1/12, 2/17 and 1/24 vs. 5/10; the clinical pregnancy rate and live birth rate in HMG subgroup, CC + HMG subgroup and LE + HMG subgroup were significantly higher than those in LE subgroup, the abortion rate was significantly lower than that in LE subgroup, and there were statistical differences ( P<0.05). Conclusions:When the patients with unexplained infertility are assisted by IUI, LE combined with HMG ovulation induction can achieve a better pregnancy outcome.