Study of various predictors influencing success with artificial insemination husband


  • Anam Ul Haq Department of Reproductive Medicine and Surgery GSL Medical College Rajahmundry Andhra Pradesh, India
  • Hima Bindu Y. Department of Reproductive Medicine and Surgery GSL Medical College Rajahmundry Andhra Pradesh, India
  • Sireesha K. V. Department of Reproductive Medicine and Surgery GSL Medical College Rajahmundry Andhra Pradesh, India
  • Kavitha Gogineni Department of Reproductive Medicine and Surgery GSL Medical College Rajahmundry Andhra Pradesh, India



AIH, Factors, Infertility, Influence


Background: Infertility effects more than 180 million people world-wide and couples should be evaluated to focus on the modifiable factors and various interventions to optimize the results before switching to costly treatments. Artificial insemination husband is one such treatment where various prognostic factors determine the success.

Methods: The present study was done in department of reproductive medicine and surgery GSL medical college .All infertile couples attending the clinic and satisfying inclusion and exclusion criteria after proper consent were enrolled for study. Various relevant prognostic factors determining outcome were analysed statistically using the chi square test, the Fischer exact test, and the one way ANNOVA test.

Results: In present study, the prevalence of positive pregnancy after IUI procedure was 14.7%. The total pregnancy rate per cycle was 10.6%. Among prognostic factors total motile sperm count, semen preparation technique and first AIH cycle showed positive correlation with the outcome.

Conclusions: According to the results of the current study, intrauterine insemination (IUI) can provide many infertile couples with an opportunity of parenting. Before beginning this type of therapy, it is crucial to make the right selection of cases and conduct a thorough assessment of the couples.


Practice Committee of American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss. Fertil Steril. 2008;90(5 Suppl):S60

Thonneau P, Marchand S, Tallec A, Ferial ML, Ducot B, Lansac J, et al. Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988-1989). Hum Reprod. 1991;6(6):811-6.

Hull MG, Glazener CM, Kelly NJ, Conway DI, Foster PA, Hinton RA, et al. Population study of causes, treatment, and outcome of infertility. Br Med J Clin Res Ed. 1985;291(6510):1693-7.

Shih KW, Shen PY, Wu CC, Kang YN. Testicular versus percutaneous epididymal sperm aspiration for patients with obstructive azoospermia: a systematic review and meta-analysis. Transl Androl Urol. 2019;8(6):631-640.

Kandavel V, Cheong Y. Does intra-uterine insemination have a place in modern ART practice? Best Pract Res Clin Obstet Gynaecol. 2018;53:3-10.

Cohlen B, Bijkerk A, Van der Poel S, Ombelet W. IUI: review and systematic assessment of the evidence that supports global recommendations. Hum Reprod Update. 2018;24(3):300-19.

Ombelet W, Deblaere K, Bosmans E, Cox A, Jacobs P, Janssen M, Nijs M. Semen quality and intrauterine insemination. Reprod BioMed. 2003;7(4):485-92.

Cabry-Goubet R, Scheffler F, Belhadri-Mansouri N, Belloc S, Lourdel E, Devaux A, et al. Effect of gonadotropin types and indications on homologous intrauterine insemination success: a study from 1251 cycles and a review of the literature. BioMed Res Inte. 2017;2017.

Anderson JE, Farr SL, Jamieson DJ, Warner L, Macaluso M. Infertility services reported by men in the United States: national survey data. Fertil Steril. 2009;91(6):2466-70.

Barratt CLR, Björndahl L, De Jonge CJ, Lamb DJ, Osorio Martini F, McLachlan R, et al. The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance-challenges and future research opportunities. Hum Reprod Update. 2017;23(6):660-80.

Van Voorhis BJ, Barnett M, Sparks AE, Syrop CH, Rosenthal G, Dawson J. Effect of the total motile sperm count on the efficacy and cost-effectiveness of intrauterine insemination and in vitro fertilization. Fertil Steril. 2001;75(4):661-8.

Merviel P, Heraud MH, Grenier N, Lourdel E, Sanguinet P, Copin H. Predictive factors for pregnancy after intrauterine insemination (IUI): an analysis of 1038 cycles and a review of the literature. Fertil Steril. 2010;93(1):79-88.

Campana A, Sakkas D, Stalberg A, Bianchi PG, Comte I, Pache T, et al. Intrauterine insemination: evaluation of the results according to the woman’s age, sperm quality, total sperm count per insemination and life table analysis. Hum Reprod. 1996;11(4):732–6.

Ombelet W, Vandeput H, Van de Putte G, Cox A, Janssen M, Jacobs P, et al. Intrauterine insemination after ovarian stimulation with clomiphene citrate: predictive potential of inseminating motile count and sperm morphology. Hum Reprod. 1997;12(7):1458-63.

Stone BA, Vargyas JM, Ringler GE, Stein AL, Marrs RP. Determinants of the outcome of intrauterine insemination: analysis of outcomes of 9963 consecutive cycles. Am J Obstet Gynecol. 1999;180(6 Pt 1):1522-34.

Astolfi P, De Pasquale A, Zonta LA. Paternal Age and Preterm Birth in Italy, 1990 to 1998. Epidemiol. 2006;17:218-21.

Slama R, Bouyer J, Windham G, Fenster L, Werwatz A, Swan SH. Influence of paternal age on the risk of spontaneous abortion. Am J Epidemiol 2005;161(9):816-23.

Reichenberg A, Gross R, Weiser M, Bresnahan M, Silverman J, Harlap S, et al. Advancing paternal age and autism. Arch Gen Psychiatry 2006;63(9):1026-32.

Ford WC, North K, Taylor H, Farrow A, Hull MG, Golding J. Increasing paternal age is associated with delayed conception in a large population of fertile couples: evidence for declining fecundity in older men. The ALSPAC Study Team (Avon Longitudinal Study of Pregnancy and Childhood). Hum Reprod. 2000;15(8):1703-8.

Hammiche F, Laven JSE, Twigt JM, Boellaard WPA, Steegers EAP, Steegers-Theunissen RP. Body mass index and central adiposity are associated with sperm quality in men of subfertile couples. Hum Reprod. 2012;27(8):2365-72.

Eisenberg ML, Kim S, Chen Z, Sundaram R, Schisterman EF, Buck Louis GM. The relationship between male BMI and waist circumference on semen quality: data from the LIFE study. Hum Reprod. 2014;29(2):193-200.

Shayeb AG, Harrild K, Mathers E, Bhattacharya S. An exploration of the association between male body mass index and semen quality. Reprod Biomed Online. 2011;23(6):717-23.

Kort HI, Massey JB, Elsner CW, Mitchell-Leef D, Shapiro DB, Witt MA, et al. Impact of body mass index values on sperm quantity and quality. J Androl 2006;27(3):450-2.

WHO Scientific Group on Recent Advances in Medically Assisted Conception, World Health Organization. Report of a WHO Scientific Group. World Health Organ Tech Rep Ser. 1992;820:1-111.

Ramsay JE, Greer I, Sattar N. ABC of obesity. Obesity and reproduction. BMJ 2006;333(7579):1159-62.

Green BB, Weiss NS, Daling JR. Risk of ovulatory infertility in relation to body weight. Fertil Steril. 1988;50(5):721-6.

Fiscella K, Franks P, Gold MR, Clancy CM. Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care. JAMA. 2000;283(19):2579-84.

Deaton JL, Clark RR, Pittaway DE, Herbst P, Bauguess P. Clomiphene citrate ovulation induction in combination with a timed intrauterine insemination: the value of urinary luteinizing hormone versus human chorionic gonadotropin timing. Fertil Steril. 1997;68(1):43-7.

Lamb JD, Huddleston HG, Purcell KJ, Modan A, Farsani TT, Dingeldein MA, et al. Asian ethnicity is associated with decreased pregnancy rates following intrauterine insemination. Reprod Biomed Online. 2009;19(2):252-6.

Kessler LM, Craig BM, Plosker SM, Reed DR, Quinn GP. Infertility evaluation and treatment among women in the United States. Fertil Steril. 2013;100(4):1025-32.

Sahakyan M, Harlow BL, Hornstein MD. Influence of age, diagnosis, and cycle number on pregnancy rates with gonadotropin-induced controlled ovarian hyperstimulation and intrauterine insemination. Fertil Steril. 1999;72(3):500-4.

Dickey RP, Holtkamp DE. Development, pharmacology and clinical experience with clomiphene citrate. Hum Reprod Update. 1996;2(6):483-506.

Randall JM, Templeton A. Cervical mucus score and in vitro sperm mucus interaction in spontaneous and clomiphene citrate cycles. Fertil Steril. 1991;56(3):465-8.

El Hachem H, Antaki R, Sylvestre C, Lapensée L, Legendre G, Bouet PE. Timing therapeutic donor inseminations in natural cycles: human chorionic gonadotrophin administration versus urinary LH monitoring. Reprod Biomed Online. 2017;35(2):174-9.

Lewis V, Queenan J, Hoeger K, Stevens J, Guzick DS. Clomiphene citrate monitoring for intrauterine insemination timing: a randomized trial. Fertil Steril. 2006;85(2):401-6.

Nuojua-Huttunen S, Tomas C, Bloigu R, Tuomivaara L, Martikainen H. Intrauterine insemination treatment in subfertility: an analysis of factors affecting outcome. Hum Reprod. 1999;14(3):698-703.

Dovey S, Sneeringer RM, Penzias AS. Clomiphene citrate and intrauterine insemination: analysis of more than 4100 cycles. Fertil Steril. 2008;90(6):2281-6.

Rahman SM, Karmakar D, Malhotra N, Kumar S. Timing of intrauterine insemination: an attempt to unravel the enigma. Arch Gynecol Obstet. 2011;284(4):1023-7.

Claman P, Wilkie V, Collins D. Timing intrauterine insemination either 33 or 39 hours after administration of human chorionic gonadotropin yields the same pregnancy rates as after superovulation therapy. Fertil Steril. 2004;82(1):13-6.

Cohlen B, Bijkerk A, Van der Poel S, Ombelet W. IUI: review and systematic assessment of the evidence that supports global recommendations. Hum Reprod Update. 2018;24(3):300-19.

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.

Hatice K, Ahmet E, Mehmet E, Mehmet FM, Nuray B. The gradient technique improves success rates in intrauterine insemination cycles of unexplained subfertile couples when compared to swim up technique: a prospective randomized study. J Assisst Reprod Genet. 2014;31:1139-1145.

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.

Shiuan YT, Yi-Xuan Lee, Cindy C, Chii-Ruey T. Prognostic factors to acheieve higher pregnancy and live birth rate in intrauterine insemination among subfertile women. Fertil Reprod. 2019;1(2):106-14.

Roshan N, Nasrin S. The influence of sperm morphology, total motile sperm count of semen and the number of motile sperm inseminated in sperm samples on the success of intrauterine insemination. Int J Fertil Steril. 2011;5(3):168-73.

Jeong M, Kim SK, Kim H, Lee JR, Jee BC, Kim SH. Predictive value of sperm motility before and after preparation for the pregnancy outcomes of intrauterine insemination. Clin Exp Reprod Med. 2021;48(3):255-61.






Original Research Articles