Optimizing Pregnancy Outcomes in Intrauterine Insemination Cycles by Stratifying Pre-wash Total Motile Count and Patient-specific Factors: a Patient Counseling Tool

Overview

Journal J Assist Reprod Genet

Publisher Springer

Specialties Genetics
Reproductive Medicine

Date 2022 Nov 7

PMID 36342575

Authors

Catherine E Gordon

Karissa C Hammer

Kaitlyn James

Andrea Lanes

Stylianos Vagios

Anabel Starosta

Mark Hornstein

Irene Souter

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study is to clarify which pre-wash total motile count are associated with improved clinical pregnancy rate (CPR) and live birth rate (LBR) based on maternal age, AMH level, stimulation regimen, and infertility diagnosis.

Methods: This was a retrospective cohort study of first completed IUI cycles at two academic fertility centers from 5/2015 to 9/2019. Cycles were stratified by pre-wash TMC, maternal age, AMH level, stimulation regimen, and infertility diagnosis. The primary outcome was CPR and secondary outcomes were live birth and miscarriage.

Results: One thousand one hundred fifty-four cycles were analyzed. Of the 162 cycles that resulted in a CPR (14.0%), most had an insemination TMC > 20 million. Compared to TMC > 20 million, there was no difference in CPR or LBR for lower TMC categories, excluding the TMC < 2 million group, in which there were no pregnancies. When TMC was stratified by deciles, there was also no difference in CPR and LBR, including within the lowest decile (TMC 0.09-8.6 million). Younger age and higher ovarian reserve parameters were associated with higher pregnancy and LBR when stratified by TMC. There was no difference in pregnancy and LBR when considering different stimulation protocols.

Conclusions: Our data suggest that pregnancy and LBR are equivalent above a TMC of 2 million. Data stratified by TMC and patient parameters can be used to counsel patients pursuing ART.

Citing Articles

Low Estradiol Level and Endometrial Thickness on the Day of Endometrial Transformation Influence Clinical Pregnancy After Intrauterine Insemination.

Tang Q, Yi H, Chen S, Zheng Y, Wen Y, Yang M Int J Gen Med. 2024; 17:1441-1449.

PMID: 38645400 PMC: 11027920. DOI: 10.2147/IJGM.S450912.

Is There Any Effect of Change in Pre-Wash and Post-Wash Semen Parameters on the Success of Intrauterine Insemination?.

Yavuzcan A, Yurtcu E, Keyif B, Osmanlioglu S J Pers Med. 2024; 14(1).

PMID: 38248745 PMC: 10820498. DOI: 10.3390/jpm14010043.

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