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Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success

  • Assisted Reproduction Technologies
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Abstract

Purpose

To report our experience on homologous intrauterine insemination (IUI) with gonadotropin controlled ovarian stimulation (COS) cycles and to examine different variables which could predict IUI success.

Materials and methods

This is a retrospective analysis of IUIs performed between January 1997 and December 2017. A total of 7359 COS IUI’s procedures (2901 couples) were reviewed. Clinical pregnancy, live birth rate and age, body mass index (BMI), smoking habit, duration of infertility, sperm characteristics before and after treatment (total motile count, morphology, and vitality), day 3 FSH, total gonadotropin dose, and number of follicles were assessed by multivariate logistic regression analysis, and data were expressed as odds ratio (OR).

Results

The mean female age at the time of COS was 35.10 ± 3.93 years. The most common single infertility diagnoses were unexplained infertility (53.55%), mild male factor (19.69%), and anovulation (10.95%). The total progressive motile sperm count (TPMC) was > 1 × 106/ml (mean 1.34 ± 1.08 × 106/ml). The clinical pregnancy rate was 9.38%, and the live birth rate was 7.19% per cycle. Twin pregnancies were 12.17%. Cumulative pregnancy was 21.89% and cumulative live birth rate was 17.58% per couple. Clinical pregnancy and live birth rates were significantly associated with female age [OR 0.97 (95% CI 0.95–0.99) and 0.95 (95% CI 0.93–0.97), respectively] and day 3 FSH [OR 0.91 (95% CI 0.87–0.94) e 0.90 (95% CI 0.87–0.94), respectively].

Conclusions

Clinical pregnancy rate and live birth rates after COS-IUIs were significantly influenced by female age and FSH levels.

Trial registration

Clinical trial registration number: NCT03836118

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Data availability

The datasets generated for this study are available on request to the corresponding author.

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Authors and Affiliations

  1. Department of Gynecology- Division of Gynecology and Reproductive Medicine- Humanitas Fertility Center, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy

    Valentina Immediata, Maria Rosaria Parisen Toldin, Camilla Ronchetti, Federico Cirillo, Annamaria Baggiani, Elena Albani & Paolo Emanuele Levi-Setti

  2. Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, Yale University, New Haven, CT, USA

    Pasquale Patrizio & Paolo Emanuele Levi-Setti

  3. Biostatistics Unit, Humanitas Cinical and Research Center IRCCS, Rozzano, Milan, Italy

    Emanuela Morenghi

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  1. Valentina Immediata
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Correspondence to Paolo Emanuele Levi-Setti.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Independent Ethical Committee of our Institution. Consent was obtained from each patient after full explanation of the purpose and nature of all procedures used.

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Immediata, V., Patrizio, P., Parisen Toldin, M.R. et al. Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success. J Assist Reprod Genet 37, 1195–1201 (2020). https://doi.org/10.1007/s10815-020-01752-3

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