Predictive Factors Affecting Outcome of Intrauterine Insemination : A Prospective Study

Original Research Article Background: Intrauterine insemination (IUI) is the therapeutic process of placing washed spermatozoa transcervically into the uterine cavity for the treatment of cervical factor subfertility, male subfertility and unexplained infertility. This prospective study was done to identify the most important parameters with regard to IUI success that would provide important data for predicting the success of therapy and further help in planning subfertility treatment for couples. Methods: It was a prospective randomized, comparative study of 406 eligible couple fulfilling inclusion criteria and exclusion undergoing 512 controlled IUI cycles, in department of Obstetrics and Gynecology, SMS Medical College, Jaipur. Patients were randomly divided at cycle level, out of total 512 cycles, 260 cycles were allocated to Clomiphene citrate (CC) group and 252 cycles were allocated to Human Menopausal Gonadotropin (HMG) group. Insemination was then performed with washed semen after 36-40 hrs of injection human chorionic gonadotropin for triggering ovulation. The patient was then called after 2 weeks for pregnancy tests which, if positive was considered as clinical pregnancy. Result: Out of 512 cycles, 59 cycles were positive. The pregnancy rate was 11.52%. Endometrial thickness, preovulatory follicle number, significantly affected the pregnancy outcome. Factors like patient’s age, Husband’s age, BMI<25, bilateral patent tubes and decreased duration of infertility also positively affected the outcome. Conclusion: IUI is a successful treatment for appropriately selected cases of infertility. A knowledge of predictive factors may be of help to offer and counsel patients regarding success of treatment outcome in IUI.