Two different timing of intra uterine insemination in patients of unexplained infertility: a randomized clinical trial

Mervat A. Elsersy

doi:10.18203/2320-1770.ijrcog20170587

Authors

Mervat A. Elsersy Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Egypt

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20170587

Keywords:

Background, Unexplained infertility is diagnosed when the basic infertility workup is found to be normal. The objective was to compare between the results of IUI performance at 24 hours or 36 hours after hCG injection in couples with unexplained infertili

Abstract

Background: Unexplained infertility is diagnosed when the basic infertility workup is found to be normal. The objective was to compare between the results of IUI performance at 24 hours or 36 hours after hCG injection in couples with unexplained infertility.

Methods: A prospective comparative study was conducted on 250 patients diagnosed with unexplained infertility who were randomly allocated in two equal groups. Each patient received ovulation induction. Follicular growth scanning was performed, patients received 10.000 hCG injection when there was mature follicle equaled to or more than 18mm. Then they randomly allocated to either group 1 who underwent IUI 24 hours after hCG injection or group 2 who underwent IUI 36 hours after hCG injection.

Results: The positive qualitative serum β -hCG test was higher in group 1 who received IUI 24 hours after hGC injection, 24%, while in group 2 who received IUI 36 hours after hGC injection, it was 16.8% but no statistical differences between the two studied groups could be observed. The most important finding in this study is that the clinical pregnancy rate in group 1 was significantly higher than in group 2.

Conclusions: Earlier IUI procedures increased the clinical pregnancy rate in patients with unexplained infertility during ovulation induction with gonadotropins. Correct timing of insemination is essential.

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References

Practice Committee of the American Society for Reproductive Medicine. Effectiveness and treatment for unexplained infertility. Fertil Steril. Nov 2006;86(5 Suppl 1):S111-4.

Ganguly I, Singh A, Bhandari S, Agrawal P, Gupta N. Pregnancy predictors after intrauterine insemination in cases of unexplained infertility: a prospective study. Int J Reprod Med. 2016;2016:5817823.

Mackenna AI, Zegers-Hochschild F, Fernandez EO, Fabres CV, Huidobro CA, Guadarrama AR. Intrauterine insemination: critical analysis of a therapeutic procedure. Hum Reprod. 1992;7(3):351-4.

Intrauterine insemination. Human reproduction update. 2009;15(3):265-277.

Matorras R, Osuna C, Exposito A, Crisol L, Pijoan JI. Recombinant FSH versus highly purified FSH in intrauterine insemination: systematic review and metaanalysis. Fertil Steril. 2011;95(6):1937-42.

Veltman M, Connor K, Honey M, Diener S, Bodily D. Collaborative practice through simulations in a multiuser virtual environment. Comput Inform Nurs. 2012;30(2):63-7.

Cantineau AE, Janssen MJ, Cohlen BJ, Allersma T. Synchronised approach for intrauterine insemination in subfertile couples. The Cochrane database of systematic reviews. 2014;(12):Cd006942.

Luciano AA, Peluso J, Koch EI, Maier D, Kuslis S, Davison E. Temporal relationship and reliability of the clinical, hormonal, and ultrasonographic indices of ovulation in infertile women. Obstet Gynecol. 1990;75(3 Pt 1):412-6.

Check JH, Zavos PM, Katsoff D, Kiefer D. Effects of Percoll discontinuous density gradients vs SpermPrep II vs Sephadex G-50 gel filtration on semen parameters. Tohoku J Experimenta Med. 1993;169(3):22531.

Yilmaz NK, Sargin A, Erkilinc S, Ozer I, Engin-Ustun Y. Does ovulation induction and intrauterine insemination affect perinatal outcomes in singletons? J Matern Fetal Neonatal Med. 2016:1-9.

Duran HE, Morshedi M, Kruger T, Oehninger S. Intrauterine insemination: a systematic review on determinants of success. Hum Reprod Update. 2002;8(4):373-84.

Khalil MR, Rasmussen PE, Erb K, Laursen SB, Rex S, Westergaard LG. Homologous intrauterine insemination. An evaluation of prognostic factors based on a review of 2473 cycles. Acta obstetricia et gynecologica Scandinavica. 2001;80(1):74-81.

Kamath MS, Bhave P, Aleyamma T. Predictive factors for pregnancy after intrauterine insemination: A prospective study of factors affecting outcome. J Hum Reprod Sci. 2010;3(3):129-34.

Demir B, Dilbaz B, Cinar O. Factors affecting pregnancy outcome of intrauterine insemination cycles in couples with favourable female characteristics. J Obstet Gynaecol. 2011;31(5):420-3.

Liu M. Capacitation-associated glycocomponents of mammalian sperm. Reprod Sci. 2016;23(5):572-94.

Huang FJ, Chang SY, Lu YJ, Kung FT, Tsai MY, Wu JF. Two different timings of intrauterine insemination for non-male infertility. J Assist Reprod Genet. 2000;17(4):213-17.

Wang YC, Chang YC, Chen IC, Cnien HH, Wu GJ. Comparison of timing of IUI in ovarian stimulated cycles. Archives Andro. 2006;52(5):371-4.

Ragni G, Somigliana E, Vegetti W. Timing of intrauterine insemination: where are we? Fertil Steril. 2004;82(1):25-6

Lin LT, Tsui KH, Wang PH. The earlier the better: When should intrauterine insemination be done? J Chin Med Assoc. 2016: (In press).

Kucuk T. Intrauterine insemination: is the timing correct? J Assist Reprod Genet. 2008;25(8):427-30.

Blockeel C, Knez J, Polyzos NP, De Vos M, Camus M, Tournaye H. Should an intrauterine insemination with donor semen be performed 1 or 2 days after the spontaneous LH rise? A prospective RCT. Hum Reprod. 2014;29(4):697-703.

Yumusak OH, Kahyaoglu S, Pekcan MK. Which is the best intrauterine insemination timing choice following exogenous hCG administration during ovulation induction by using clomiphene citrate treatment? A retrospective study. Springerplus. 2016;5(1):1307.