Intrauterine insemination: prognostic factors

• Published in: JBRA assisted reproduction Vol. 28; no. 2; pp. 254 - 262
• Main Authors: Dias, Carla Maria Franco, Vitorino, Gabriel Borges Tavares, Furlan, Suelen Maria Parizotto, Reis, Rosana Maria Dos, Silva, Ana Carolina Japur de Sá Rosa E, Mendes, Maria Célia, Ferriani, Rui Alberto, Navarro, Paula Andrea
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Reprodução Humana (Brazilian Society of Assisted Reproduction) 2024; Brazilian Society of Assisted Reproduction
• Subjects: Adult; Birth control; Body mass index; Drug dosages; Female; Follicles; Humans; In vitro fertilization; Infertility; Insemination, Artificial - methods; Male; Medical prognosis; Menstruation; Motility; Original; Ovaries; Ovulation; Ovulation Induction - methods; Pregnancy; Pregnancy Outcome - epidemiology; Pregnancy Rate; Prognosis; Reproductive health; Retrospective Studies; Sperm; Ultrasonic imaging; prognostic factors; infertility; clinical pregnancy rate; intrauterine insemination; live birth rate
• ISSN: 1518-0557; 1517-5693; 1518-0557
• DOI: 10.5935/1518-0557.20240017

To evaluate the impact of possible maternal and paternal prognostic factors and ovarian stimulation protocols on clinical pregnancy and live birth rates in intrauterine insemination (IUI) cycles. Retrospective observational study of 341 IUI cycles performed from January 2016 to November 2020 at the Assisted Reproduction Service of the Clinics Hospital of the Ribeirão Preto Medical School, University of São Paulo. Clinical pregnancy and live birth rates and their potential prognostic factors were evaluated. Wilcoxon's non-parametric test was used to compare quantitative variables, and the chi-square test to compare qualitative variables, adopting a significance level of p<0.05. A logistic regression model was performed to verify which exploratory variables are predictive factors for pregnancy outcome. The ovulation induction protocol using gonadotropins plus letrozole (p=0.0097; OR 4.3286, CI 1.3040 - 14.3684) and post-capacitation progressive sperm ≥ 5million/mL (p=0.0253) showed a statistically significant correlation with the live birth rate. Female and male age, etiology of infertility, obesity, multifollicular growth, endometrial thickness ≥ 7 mm, and time between human chorionic gonadotropin administration and IUI performance were not associated with the primary outcomes. In the group of patients with ideal characteristics (women aged< 40 years, BMI < 30 kg/m2, antral follicle count ≥ 5, partner aged< 45 years, and post-capacitation semen with progressive spermatozoa ≥ 5 million/mL), the rate of clinical pregnancy was 14.8%, while that of live birth, 9.9%. In this study, the ovulation induction protocol with gonadotropins plus letrozole and post-capacitation progressive sperm ≥ 5 million/mL were the only variables that significantly correlated with intrauterine insemination success.