Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: mate
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ASSISTED REPRODUCTION TECHNOLOGIES
Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success Valentina Immediata 1 & Pasquale Patrizio 2 & Maria Rosaria Parisen Toldin 1 & Emanuela Morenghi 3 & Camilla Ronchetti 1 & Federico Cirillo 1 & Annamaria Baggiani 1 & Elena Albani 1 & Paolo Emanuele Levi-Setti 1,2 Received: 30 October 2019 / Accepted: 17 March 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
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 Keywords Intrauterine Insemination . Infertility . Maternal Age . Ovarian Reserve
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10815-020-01752-3) contains supplementary material, which is available to authorized users. * Paolo Emanuele Levi-Setti [email protected] 1
Department of Gynecology- Division of Gynecology and Reproductive Medicine- Humanitas Fertility Center, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
2
Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, Yale University, New Haven, CT, USA
3
Biostatistics Unit, Humanitas Cinical and Research Center IRCCS, Rozzano, Milan, Italy
Infertility affects one in seven couples [1], and it has been recognized as a public h
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