Prognosis factors of pregnancy after intrauterine insemination with the husband's sperm: conclusions of an analysis of 2,019 cycles

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• 作者：Laka Dinelli ; M.D.^a ; Blandine Courbiè ; re ; M.D. ; Ph.D.^a ; ^b ; Vincent Achard ; M.D. ; Ph.D.^a ; ^c ; Elisabeth Jouve ; M.Sc.^d ; Carole Deveze ; M.D.^a ; Audrey Gnisci ; M.D.^a ; Jean-Marie Grillo ; M.D. ; Ph.D.^a ; ^c ; Odile Paulmyer-Lacroix ; M.D. ; Ph.D.^a ; ^c ; ^{odile.lacroix-paulmyer@ap-hm.fr" class="auth_mail}
• 关键词：Delivery rate ; husband's sperm ; intrauterine insemination ; pregnancy rate ; prognosis factor
• 刊名：Fertility and Sterility
• 出版年：April, 2014
• 年：2014
• 卷：101
• 期：4
• 页码：994-1000
• 全文大小：186 K

文摘

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Objective

To identify the prognostic factors for pregnancy after intrauterine insemination with the husband's sperm (IUI-H).

Design

Retrospective study.

Setting

A single university medical center.

Patient(s)

851 couples, for 2,019 IUI-H cycles.

Intervention(s)

After controlled ovarian stimulation, IUI-H performed 36聽hours after ovulation triggering or 24聽hours after a spontaneous luteinizing hormone (LH) surge.

Main Outcome Measure(s)

Clinical pregnancy rate per cycle (PR) and delivery rate per cycle (DR).

Result(s)

The overall PR was 14.8% and DR 10.8%. Higher PR and DR were observed for patients presenting with ovulation disorders (particularly polycystic ovary syndrome) or with male infertility. Secondary infertility in the woman appeared to be a positive prognostic factor as did a basal follicle-stimulating hormone (FSH) level 鈮? IU/L and ovulation triggering over spontaneous LH rise. The other parameters influencing the results were the women's age, the number of mature follicles obtained (鈮?), the endometrial thickness (10-11聽mm), and the number of progressive motile spermatozoa inseminated (>1 million).

Conclusion(s)

In women aged 鈮?8聽years, IUI-H should be considered as an option, particularly in cases of female infertility from ovulation disorders, in cases of a normal ovarian reserve, in cases of secondary infertility, or when 鈮? million progressive sperm are inseminated. Bifollicular stimulation is required. In other cases, in聽vitro fertilization should be discussed as the first-line treatment.