Publication:

Evaluation of female prognostic factors influencing pregnancy rate after intrauterine insemination with controlled ovarian hyper stimulation in infertile couples in a tertiary care hospital

Background To study the influence of various female prognostic factors on the outcome of pregnancy.

Methods A Prospective observational study was conducted in the department of obstetrics and gynaecology to study the effect of different female prognostic variables in a total of 200 couples who underwent 541 cycles with controlled ovarian hyperstimulation. Variables selected for analysis were female age, menstrual history, duration of infertility, number of cycles, number dominant follicle diameter, endometrial thickness.

Results A total of 541 IUI cycles in 200 women resulted in 65 pregnancies. The average pregnancy rates were 12% per cycle and 33% per couple. Multiple pregnancy rates were 7.6%mostly with clomiphene citrate. Endometrial thickness of more than 1 mm, ovulation stimulation protocol with clomiphene citrate plus recombinant FSH, day of insemination after 16thday, duration of infertility of less than 5 years and treatment with less than 5 cycles has been proved as the significant prognostic variables for successful IUI. Stimulation with sequential clomiphene citrate and recombinant FSH resulted in best pregnancy rates with low multiple pregnancy rates.

Conclusions Careful selection of subjects, appropriate controlled ovarian stimulation and intra uterine insemination lead to good pregnancy rates with low multiple pregnancy.