PREGNANCY WITH INTRAUTERINE INSEMINATION AND OVULATION STIMULATION WITH CLOMIPHENE CITRATE
Abstract
Background. The aim of our study was to asses the success of the method of intrauterine insemination (IUI) and ovulation stimulation with clomiphene citrat compared to other techniques of assisted reproductive technology (AR).
Methods. In retrograde, 533 cycles of IUI were analysed in 204 infertile couples. The success of IUI was compared according to the most common indications, the patients age and the successive cycle of IUI. The different values of the variables were compared using Pearson’s Chi-square test.
Results. The overall pregnancy rate was 6.7%. The success was 2.35% in couples with a tubal cause of infertility (with one side tubal pathology), 12.12% in couples with male infertility only and 7.33% in couples with idiopathic infertility. The differences in the results of IUI between the age groups of female patients were not statistically significant.
Conclusions. IUI is painless, noninvasive and less expensive method of AR and has therefore an important role for the treatment of infertility. IUI is suitable mainly for idiopathic infertility, some forms of male infertility and oligo – anovulations and if there are no contraindications we recommend it as treatment before IVF program.
Downloads
References
Čerkez-Habek J, Šimunić V, Habek D. Uspješnost intrauterine inseminacije sjemenom supruga ili sjemenom donora u liječenju bračne neplodnosti. Gynaecol Perinatol 1998; 7: 157–60.
Kahn JA. Assisted procreation. The efficiency and efficacy of fallopian tube sperm perfusion (FSP) and in vitro fertilisation (IVF). Norway: University of Trondheim, 1993.
Ograjenšek Z. Umetna osemenitev: In: Meden-Vrtovec H et al. Neplodnost. Ljubljana: Cankarjeva založba, 1989: 363–6.
Karlstrom PO, Bergh T, Lundkvist O. A prospective randomized trial of artificial insemination versus intercourse in cycles stimulated with human menopausal gonadotropin or clomiphene citrate. Fertil Steril 1993; 59: 554– 9.
Sahakyan M, Harlow BL, Hornstein MD. Influence of age, diagnosis, and cycle number on pregnancy rates with gonadotropin – induced controlled ovarian hyperstimulation and intrauterine insemination. Fertil Steril 1999; 72: 500–4.
Arici A, Byrd W, Bradshaw K, Kutteh WH, Marshburn P, Carr BR. Evaluation of clomiphene citrate and human chorionic gonadotropin treatment: a prospective, randomized, crossover study during intrauterine insemination cycles. Fertil Steril 1994; 61: 314–8.
Zikopoulos K, West CP, Thong PW, Kacser EM, Morrison J, Wu FCW. Homologous intrauterine insemination has no advantage over timed natural intercourse when used in combination with ovulation induction for the treatment of unexplained infertility. Hum Reprod 1993; 8: 563–7.
Zorn B, Đukanović S, Drobnič S, Virant-Klun I, Kolbezen-Simoniti M, BokalVrtačnik E. Intrauterine insemination: evaluation of the results according to the woman’s age, semen quality and type of ovarian stimulation. Gynaecol Perinatol 1997; 6: 129–32.
Tomlinson MJ, Amissah-Arthur JB, Thomson KA, Kasraie JL, Bentick B. Prognostic indicators for intrauterine insemination (IUI): statistical model for IUI success. Hum Reprod 1996; 11: 1892–6.
Plosker SM, Jacobson W, Amato P. Predicting and optimizing success in intrauterine insemination programme. Hum Reprod 1994; 9: 2014–20.
Kahn JA, Von During V, Sunde A, Sordal T, Molne K. Fallopian tube sperm perfusion: first clinical experience. Hum Reprod 1992; 7: 19–24.
Mathieu C, Ecochard R, Bied V. Cumulative conception rate following intrauterine artificial insemination with husband’s spermatozoa: influence of husband’s age. Hum Reprod 1995; 10: 1090–7.
Frederick JL, Denker MS, Rojas A, Horta I, Stone SC, Asch RH et al. Is there a Role for ovarian stimulation and intrauterine insemination after age 40? Hum Reprod 1994; 9: 84–6.
Brzechffa PR, Daneshmand S, Buyalos RP. Sequential clomiphene citrate and human menopausal gonadotrophin with intrauterine insemination: the effect of patient age on clinical outcome. Hum Reprod 1998; 13: 2110–4.
Ragni G, Maggioni P, Guermandi E, Testa A, Baroni E, Colombo M et al. Efficacy of double intrauterine insemination in controlled ovarian hyperstimulation cycles. Fertil Steril 1999; 72: 619–22.
Dickey RP, Olar TT, Taylor SN, Curole DN, Rye PH. Sequential clomiphene citrate and human menopausal gonadotrophin for ovulation induction: comparison to clomiphene citrate alone and human menopausal gonadotrophin alone. Hum Reprod 1993; 3: 56–9.
El Sadek MM, Amer MK, Abdel-Malak G. Questioning the efficacy of Fallopian tube sperm perfusion. Hum Reprod 1998; 13: 3053–6.
Vlaisavljević V, Kovačič B, Gavrić-Lovrec V, Reljič M. Simplification of the clinical phase of IVF and ICSI treatment in programmed cycles. Int J Gynecol Obstet 2000; 47: 1–7.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
