Pregnancy Predictors after Intrauterine Insemination in Case of Unexplained Infertility

Abstract

Background: IUI procedure is widely applied around the world. The aim of IUI is to put a prepared small volume of active motile sperm high in the uterine cavity, on the period of ovulation. In many centers IUI is usually applied in  combination with ovulation induction or Controlled ovarian hyperstimulation (COH). however, the successful rate of getting pregnancy with IUI remains unchanged. 
Aim  of  study:  To  clarify  the  prognostic  factors  effect    in  cases  of unexplained infertility offered  intrauterine insemination with controlled ovarian stimulation.
Patients  and  methods:  This  is  a  prospective  cohort  study  has  been conducted  in  Salahadeen  General  hospital  (Iraq/Tikrit  City)  from December 2017 to August 2018. A 45 couples of unexplained infertility were included, a maximum of 3 cycles of IUI were done with clomiphene citrate,  HMG.  Ovulation  trigger  was  given  when  the  largest  follicle diameter around 18 mm. and IUI was planned within 36hrs. later
Results: A50 cycles of IUI were entered into the study among 45 couples. From these cycles, conceptions resulted, giving an overall total pregnancy rate per cycle of 12%. Cycles per couple were ranged from one to three. The mean age of the male patients was  (37year) and (33year) for the female patients. The mean of  duration of infertility was (9.5year) in couples who got pregnancy while was (5.04year) in those who got no pregnancy. The pregnancy rate was higher in the age group of (25-29 yrs) and (more than 35ys). The pregnancy rate was higher in cycle with one follicle. 
Conclusion:  In  this  study  different  factors  had  been  studied  like couple`s  age,  duration  of  infertility,  number    and  size  of  follicles, number  of  treatment  cycles,  semen  parameters  and  duration  of stimulation were used to predict the success rate but all were not significant. There was significant difference in the pregnancy rate in cases of primary (12.5%) and secondary infertility (11.5%) group (p value=0.042).  The overall pregnancy rate per cycle in our study was 12%.