The objective of this retrospective study was to evaluate the outcomes of intrauterine insemination(IUI) in infertile patients and to investigate the prognostic factors affecting pregnancy results in IUI. From March, 1993 to February, 1996, a
total
of
123 cycles of IUI in 55 infertile patients were analyzed statistically. Exclusion criteria in this study were the patients ages≥38 years, high basal serum FSH(≥25mIU/mL), hypothalamic pituitary failure, and previous history of pregnancy by
means
of
IUI.
The mean age of study group was 31.7 years, and the mean duration of infertility was 54.5 months. The overall clinical pregnancy rate(PR) was 8.9%(11/123) per cycle and 20.0%(11/55) per patient, and the rates of ectopic pregnancy and multiple
pregnancy
were the same as 9.1%(1/11). The spontaneous PR with natural intercourse was 5.5(3/55) per patient. The PR was the highest in patients with ovulatory dysfunction as their infertility factor(25.0%per patient). As the number of IUI trials
increased,
the
cumlative pregnancy rate(CPR) was decreased from 9.1% to 8.1% cycle. In cycles using gonadotropins such as hMG or FSH as their regimen of controlled ovarian hyperstimulation(COH), the PR was higher, compared with those using clomiphene
citrate(CC).
The
PR in cycles with 3 mature follicles(diameter ≥16 mm) on hCG administration day was higher than those with 1 or 2 mature follicles, but the largest follicular diameter on hCG administration day was not correlated with the PR. In cycles with
premature
LH surge, no pregnancy occurred, wherease the PR was 15.0% in cycles without premature LH surge. Between pregnant and nonpregnant groups, there were no significant differences in age of patients, duration of infertility, number of IUI trials,
diameter
of the largest follicles, number of mature follicles, and length of follicular phase.
In conclusion, IUI is a rather simple, safe and cost-effective treatment modality in the management of infertility, and the use of gonadotropins for COH may improve a pregnancy rate significantly in IUI.
|