Performing IUI Simultaneously with hCG Administration Does Not Compromise Pregnancy Rate: A Retrospective Cohort Study.

BACKGROUND: The probability of conception occurs before ovulation in natural cycle, thus performing IUI before ovulation should not compromise the pregnancy outcomes. METHODS: A retrospective cohort study was conducted at a university hospital during 2007 to 2015. The ovarian stimulation and monitoring were performed as usual. The total of 29 preovulatory IUI, and 221 postovulatory IUI couples were recruited. In postovulatory IUI, 5,000 IU of hCG was injected when dominant follicle reached 17 mm. The IUI was performed 36 to 40 hr afterward. In preovulatory IUI, hCG was injected and IUI was performed simultaneously when the dominant follicle reached the size. Data were compared using independent sample t test and Fisher's exact test. A p-value of <0.05 was considered statistically significant. RESULTS: The characteristics of both groups were comparable. The cumulative biochemical, clinical, and live birth rates were not different between prevulatory and postovulatory IUI groups (10.3% vs. 16.3%; p=0.407, 10.3% vs. 12.2%; p=0.77 and 10.3% vs. 11.3%; p=0.877, respectively). CONCLUSION: Performing IUI simultaneously with hCG administration does not compromise pregnancy rate.

The Influence of Women Age and Successfulness of Intrauterine Insemination (IUI) Cycles.

OBJECTIVE: To evaluate the association between success and the benefit of repeated intrauterine insemination (IUI) cycles among women of different age groups. MATERIAL AND METHOD: A retrospective analysis of 466 IUI cycles from 221 patients treated in afertility center of a university hospital between 2005 and 2013. The female age was stratified as younger than 35 years, 35 to 40 years, and older than 40 years old. The outcomes were the biochemical pregnancy rate, clinical pregnancy rate, live birth rate, and miscarriage rate. Kaplan-Meier analysis of the suitability cycle in each age group was also performed. RESULTS: The average age ofpatients was 35.2±4.6 years (range 21 to 49 years). The overall biochemical pregnancy rate was 18.6%. The biochemical pregnancy rate significantly decreased with advancing female age groups (27.6%, 12.8%, and 7.1% infemale age group younger than 35 years, 35 to 40 years, and older than 40 years respectively, p = 0.008). The other pregnancy outcomes were not different among female age groups. In all age groups, the increment of the cumulative biochemical pregnancy rate was observed up to four cycles. CONCLUSION: The biochemical pregnancy rate of IUI cycle decreased with advancingfemale age; however clinical pregnancy rate, live birth rate, and miscarriage rate were not different among female age groups. We recommend performing up to four insemination cycles before proceeding to IVF/ICSI cycle.

Pain control in laparoscopic gynecologic surgery with/without preoperative (preemptive) parecoxib sodium injection: a randomized study.

OBJECTIVE: To determine the effectiveness of preoperative parecoxib sodium injection for pain relief after laparoscopic gynecologic surgery. MATERIAL AND METHOD: A prospective double-blind, randomized study was conducted in 268 patients who underwent laparoscopic gynecologic surgery at Vajira Hospital between November 1, 2010 and March 31, 2011. The patients were randomly allocated into two groups to receive either single intravenous 40 mg parecoxib (treatment group; n = 133) or normal saline (control group; n = 135) 30 min before surgery. The degree of postoperative pain was assessed every 2 h in the first 8 h postoperation, then every 4 h until completion of 24 h by using a verbal rating scale. Total consumption of meperidine over a 24-h period and the adverse events relevant to parecoxib sodium were also recorded. RESULTS: Mean pain scores at all measured times in the treatment group were insignificantly lower than those in the control group (p = 0.106). The mean 24-h postoperative meperidine consumption in the treatment group was significantly lower compared to that in the control group (26.3 +/- 28.1 mg and 39.1 +/- 34.6 mg, respectively, p = 0.001). The proportion of patients requiring meperidine in the treatment group was significantly lower than that in the control group (58.6% and 70.3%, respectively, p = 0. 045). No serious adverse events were observed in both groups. CONCLUSION: Preoperative parecoxib sodium significantly reduced postoperative meperidine requirement and consumption, while insignificantly declined the pain scores. Serious adverse events were not encountered