Prognostic indicators for intrauterine insemination (IUI): statistical model for IUI success.

A retrospective analysis of 260 completed intrauterine insemination (IUI) cycles was used in an attempt to identify significant variables predictive of treatment success. Couples received a maximum of three IUI cycles for the treatment of anovulation, cervical factors or unexplained infertility. Male factor problems were largely excluded by pretreatment screening. The overall pregnancy rate was 19.6% per completed cycle, the miscarriage rate 15.6%, the multiple pregnancy rate 23.5% and the cancellation rate 19%. Logistic regression identified four significant IUI variables [follicle number (P < 0.005), endometrial thickness (P < 0.005), duration of infertility (P < 0.01) and progressive motility (P < 0.05)] which were the most predictive of IUI success. The chance of conceiving when only one follicle was produced was only 7.6%, whereas with two follicles this chance increased to 26%. These variables were incorporated into a statistical model to allow the prediction of the chance of success in subsequent cycles. We conclude that careful patient selection criteria coupled with successful ovarian stimulation is the model for IUI success.

Low birth weight, prematurity, and postpartum endometritis. Association with prenatal cervical Mycoplasma hominis and Chlamydia trachomatis infections.

We studied associations of Mycoplasma hominis, Ureaplasma urealyticum, and Chlamydia trachomatis genital infections with pregnancy outcomes, controlling by logistic and multiple linear regression for known risk factors and for the presence of the other two infections. A sample of 1204 Navajo women enrolling for prenatal care had endocervical C trachomatis, M hominis, and U urealyticum cultures and serum samples taken at enrollment and when possible after 30 weeks. Low birth weight (less than 2500 g) was associated with M hominis infection among women with a history of spontaneous abortion. Mycoplasma hominis infection was also associated with postpartum endometritis, but only among women undergoing a cesarean section (odds ratio, 4.7; 95% confidence intervals, 1.22 to 18.3). Although women with recent C trachomatis infection (IgM titer greater than 1:32 on either sample or IgG seroconversion) were at greater risk of low birth weight (19% [3/16]) than women with chronic infection (4.5% [6/133]; relative risk, 4.2), this subgroup at risk was small (11% of women with classifiable C trachomatis infection). Mycoplasma hominis and C trachomatis infections may be important preventable causes of adverse pregnancy outcomes in identifiable subgroups of women.