Evaluating the relationship between intrauterine insemination outcome and special causes of infertility

Common treatment for infertile couples is the use of controlled ovulation hyperstimulation (COH) with intrauterine inseminations (IUI). IUI is used in cases such as ovulatory dysfunction, cervical factor infertility, male subfertility, and unexplained infertility. In this study, we evaluated the relationship between IUI outcome and special causes of infertility.

This was a cross-sectional study and a sampling method was available in this study, from January 2014 to August 2016, 994 cycles in 803 infertile couples referred to Royan Research Institute in Tehran were analyzed. Inclusion criteria were: male factor infertility, combined causes, ovarian disease, and infertility of unknown cause. To evaluate pregnancy, 12-16 days after IUI, it was considered positive if pregnancy test followed by transvaginal ultrasound at week 4 after IUI were positive. Data were analyzed using SPSS software, version 20. T-test and chi-square were used to compare the case and control groups. Linear-by-linear test was also used to calculate the relationship between female age and clinical and multiple success rates. P<0.05 was considered significant for the results of these tests.

The success rate of pregnancy in all cycles (16.5%) and live birth rate per cycle (14.5%) were calculated. The mean age in the pregnant group was significantly lower than that of the non-pregnant group (P = 0.01).  Our findings were: Infertility with unknown cause (290 people, 29.2%), male factor (395 people, 39.7%), ovulation disorders (201 people, 20.2%) [which include: decreased ovarian reserve (1 person) 0.5%), polycystic ovary syndrome (188 patients, 93.5%) and hypothalamic amenorrhea (12 patients, 6%)] and a combination of different factors (108 patients, 10.9%). There was also a significant relationship between the cause of infertility and clinical pregnancies (P<0.001). A Significant decrease in pregnancy success rate was observed with increasing infertility duration (OR=0.8, CI=0.8-0.9, P<0.001).

Women’s age, etiology of infertility, duration of infertility, irregular menstruation, semen volume, and gonadotropin dose were important factors in COH+IUI cycles.