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Cited by 24Reproductive Health and TechnologiesAssisted Reproductive Technology and Twin PregnancyReproductive Biology and Fertility

Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success

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Immediata, Valentina, Patrizio, Pasquale, Parisen Toldin, Maria Rosaria, Morenghi, Emanuela, Ronchetti, Camilla, Cirillo, Federico, Baggiani, Annamaria, Albani, Elena +1 more·2020·Journal of Assisted Reproduction and Genetics
DOI 10.1007/s10815-020-01752-3PMC PMC7244676
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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 × 10 6/ml (mean 1.34 ± 1.08 × 10 6/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.

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  • The finding that sperm morphology had no impact on pregnancy rates after IUI was confirmed later on a larger cohort.

    “This finding was confirmed later on a larger cohort [75].”

    From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [75]

    The Discussion reports that semen parameters, including the morphology assessed in Methods, showed no impact on clinical outcomes in this large IUI cohort, provided post-treatment sperm counts met the study’s eligibility threshold. But the Results also report significantly better pretreatment normal morphology in the pregnant group. The unqualified claim therefore misses both the univariable finding and the study’s restriction. (LLM, conf=0.84)

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Research works printed but not linked: 32

  1. [1]Templeton A. Infertility-epidemiology, aetiology and effective management. Health Bull (Edinb) 1995;53:294–298. [PubMed] [Google Scholar]
  2. [3]Ombelet W. The revival of intrauterine insemination: evidence-based data have changed the picture. Facts Views Vis Obgyn. 2017;9:131–132. [PMC free article] [PubMed] [Google Scholar]
  3. [4]Cohlen B, Bijkerk A, Van der Poel S, Ombelet W. IUI: review and systematic assessment of the evidence that supports global recommendations. Hum Reprod Update. 2018;24:300–319. doi: 10.1093/humupd/dmx041. [DOI] [PubMed] [Google Scholar] · DOI
  4. [5]Group ECW Intrauterine insemination. Hum Reprod Update. 2009;15:265–277. doi: 10.1093/humupd/dmp003. [DOI] [PubMed] [Google Scholar] · DOI
  5. [6]O'Flynn N. Assessment and treatment for people with fertility problems: NICE guideline. Br J Gen Pract. 2014;64:50–51. doi: 10.3399/bjgp14X676609. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  6. [7]Bhattacharya S, Harrild K, Mollison J, Wordsworth S, Tay C, Harrold A, et al. Clomifene citrate or unstimulated intrauterine insemination compared with expectant management for unexplained infertility: pragmatic randomised controlled trial. BMJ. 2008;337:a716. doi: 10.1136/bmj.a716. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  7. [8]Reindollar RH, Regan MM, Neumann PJ, Levine BS, Thornton KL, Alper MM, Goldman MB. A randomized clinical trial to evaluate optimal treatment for unexplained infertility: the fast track and standard treatment (FASTT) trial. Fertil Steril. 2010;94:888–899. doi: 10.1016/j.fertnstert.2009.04.022. [DOI] [PubMed] [Google Scholar] · DOI
  8. [9]Wordsworth S, Buchanan J, Mollison J, Harrild K, Robertson L, Tay C, Harrold A, McQueen D, Lyall H, Johnston L, Burrage J, Grossett S, Walton H, Lynch J, Johnstone A, Kini S, Raja A, Templeton A, Bhattacharya S. Clomifene citrate and intrauterine insemination as first-line treatments for unexplained infertility: are they cost-effective? Hum Reprod. 2011;26:369–375. doi: 10.1093/humrep/deq315. [DOI] [PubMed] [Google Scholar] · DOI
  9. [10]Farquhar CM, Liu E, Armstrong S, Arroll N, Lensen S, Brown J. Intrauterine insemination with ovarian stimulation versus expectant management for unexplained infertility (TUI): a pragmatic, open-label, randomised, controlled, two-Centre trial. Lancet. 2018;391:441–450. doi: 10.1016/S0140-6736(17)32406-6. [DOI] [PubMed] [Google Scholar] · DOI
  10. [11]Nandi A, El-Toukhy T. Stimulated intrauterine insemination for unexplained subfertility. Lancet. 2018;391:404–405. doi: 10.1016/S0140-6736(17)33038-6. [DOI] [PubMed] [Google Scholar] · DOI
  11. [12]Bensdorp AJ, Tjon-Kon-Fat RI, Bossuyt PM, Koks CA, Oosterhuis GJ, Hoek A, et al. Prevention of multiple pregnancies in couples with unexplained or mild male subfertility: randomised controlled trial of in vitro fertilisation with single embryo transfer or in vitro fertilisation in modified natural cycle compared with intrauterine insemination with controlled ovarian hyperstimulation. BMJ. 2015;350:g7771. doi: 10.1136/bmj.g7771. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  12. [13]Tjon-Kon-Fat RI, Bensdorp AJ, Bossuyt PM, Koks C, Oosterhuis GJ, Hoek A, Hompes P, Broekmans FJ, Verhoeve HR, de Bruin JP, van Golde R, Repping S, Cohlen BJ, Lambers MD, van Bommel P, Slappendel E, Perquin D, Smeenk J, Pelinck MJ, Gianotten J, Hoozemans DA, Maas JW, Groen H, Eijkemans MJ, van der Veen F, Mol BW, van Wely M. Is IVF-served two different ways-more cost-effective than IUI with controlled ovarian hyperstimulation? Hum Reprod. 2015;30:2331–2339. doi: 10.1093/humrep/dev193. [DOI] [PubMed] [Google Scholar] · DOI
  13. [14]Luco SM, Agbo C, Behr B, Dahan MH. The evaluation of pre and post processing semen analysis parameters at the time of intrauterine insemination in couples diagnosed with male factor infertility and pregnancy rates based on stimulation agent. A retrospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2014;179:159–162. doi: 10.1016/j.ejogrb.2014.05.003. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  14. [15]Dinelli L, Courbière B, Achard V, Jouve E, Deveze C, Gnisci A, Grillo JM, Paulmyer-Lacroix O. Prognosis factors of pregnancy after intrauterine insemination with the husband's sperm: conclusions of an analysis of 2,019 cycles. Fertil Steril. 2014;101:994–1000. doi: 10.1016/j.fertnstert.2014.01.009. [DOI] [PubMed] [Google Scholar] · DOI
  15. [16]Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, Sullivan E, Vanderpoel S, International Committee for Monitoring Assisted Reproductive Technology. World Health Organization International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92:1520–1524. doi: 10.1016/j.fertnstert.2009.09.009. [DOI] [PubMed] [Google Scholar] · DOI
  16. [17]Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, Rienzi L, Sunde A, Schmidt L, Cooke ID, Simpson JL, van der Poel S. The international glossary on infertility and fertility care, 2017. Fertil Steril. 2017;108:393–406. doi: 10.1016/j.fertnstert.2017.06.005. [DOI] [PubMed] [Google Scholar] · DOI · Paper page
  17. [18]Duran HE, Morshedi M, Kruger T, Oehninger S. Intrauterine insemination: a systematic review on determinants of success. Hum Reprod Update. 2002;8:373–384. doi: 10.1093/humupd/8.4.373. [DOI] [PubMed] [Google Scholar] · DOI
  18. [20]Campana A, Sakkas D, Stalberg A, Bianchi PG, Comte I, Pache T, Walker D. Intrauterine insemination: evaluation of the results according to the woman's age, sperm quality, total sperm count per insemination and life table analysis. Hum Reprod. 1996;11:732–736. doi: 10.1093/oxfordjournals.humrep.a019244. [DOI] [PubMed] [Google Scholar] · DOI
  19. [21]Thijssen A, Creemers A, Van der Elst W, Creemers E, Vandormael E, Dhont N, et al. Predictive value of different covariates influencing pregnancy rate following intrauterine insemination with homologous semen: a prospective cohort study. Reprod BioMed Online. 2017;34:463–472. doi: 10.1016/j.rbmo.2017.01.016. [DOI] [PubMed] [Google Scholar] · DOI · Paper page
  20. [22]Wiser A, Shalom-Paz E, Reinblatt SL, Son WY, Das M, Tulandi T, Holzer H. Ovarian stimulation and intrauterine insemination in women aged 40 years or more. Reprod BioMed Online. 2012;24:170–173. doi: 10.1016/j.rbmo.2011.11.007. [DOI] [PubMed] [Google Scholar] · DOI
  21. [23]Merviel P, Heraud MH, Grenier N, Lourdel E, Sanguinet P, Copin H. Predictive factors for pregnancy after intrauterine insemination (IUI): an analysis of 1038 cycles and a review of the literature. Fertil Steril. 2010;93:79–88. doi: 10.1016/j.fertnstert.2008.09.058. [DOI] [PubMed] [Google Scholar] · DOI
  22. [25]Soria M, Pradillo G, García J, Ramón P, Castillo A, Jordana C, Paricio P. Pregnancy predictors after intrauterine insemination: analysis of 3012 cycles in 1201 couples. J Reprod Infertil. 2012;13:158–166. [PMC free article] [PubMed] [Google Scholar]
  23. [26]Collins JA, Burrows EA, Wilan AR. The prognosis for live birth among untreated infertile couples. Fertil Steril. 1995;64:22–28. doi: 10.1016/S0015-0282(16)57650-X. [DOI] [PubMed] [Google Scholar] · DOI
  24. [27]Snick HK, Snick TS, Evers JL, Collins JA. The spontaneous pregnancy prognosis in untreated subfertile couples: the Walcheren primary care study. Hum Reprod. 1997;12:1582–1588. doi: 10.1093/humrep/12.7.1582. [DOI] [PubMed] [Google Scholar] · DOI
  25. [28]Nuojua-Huttunen S, Tomas C, Bloigu R, Tuomivaara L, Martikainen H. Intrauterine insemination treatment in subfertility: an analysis of factors affecting outcome. Hum Reprod. 1999;14:698–703. doi: 10.1093/humrep/14.3.698. [DOI] [PubMed] [Google Scholar] · DOI
  26. [30]Merviel P, Cabry R, Lourdel E, Barbier F, Scheffler F, Mansouri N, Devaux A, Benkhalifa M, Copin H. Intrauterine insemination. Rev Prat. 2014;64:87–91. [PubMed] [Google Scholar]
  27. [31]Cabry-Goubet R, Scheffler F, Belhadri-Mansouri N, Belloc S, Lourdel E, Devaux A, et al. Effect of gonadotropin types and indications on homologous intrauterine insemination success: a study from 1251 cycles and a review of the literature. Biomed Res Int. 2017;2017:3512784. doi: 10.1155/2017/3512784. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  28. [32]Vlahos NF, Coker L, Lawler C, Zhao Y, Bankowski B, Wallach EE. Women with ovulatory dysfunction undergoing ovarian stimulation with clomiphene citrate for intrauterine insemination may benefit from administration of human chorionic gonadotropin. Fertil Steril. 2005;83:1510–1516. doi: 10.1016/j.fertnstert.2004.11.049. [DOI] [PubMed] [Google Scholar] · DOI
  29. [33]van Weert JM, Repping S, Van Voorhis BJ, van der Veen F, Bossuyt PM, Mol BW. Performance of the postwash total motile sperm count as a predictor of pregnancy at the time of intrauterine insemination: a meta-analysis. Fertil Steril. 2004;82:612–620. doi: 10.1016/j.fertnstert.2004.01.042. [DOI] [PubMed] [Google Scholar] · DOI · Paper page
  30. [34]Mankus EB, Holden AE, Seeker PM, Kampschmidt JC, McLaughlin JE, Schenken RS, Knudtson JF. Prewash total motile count is a poor predictor of live birth in intrauterine insemination cycles. Fertil Steril. 2019;111:708–713. doi: 10.1016/j.fertnstert.2018.12.025. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  31. [35]Pereira N. Total motile count as predictor of live birth in intrauterine insemination cycles. Fertil Steril. 2019;111:674. doi: 10.1016/j.fertnstert.2019.02.026. [DOI] [PubMed] [Google Scholar] · DOI
  32. [36]Bensdorp AJ, Cohlen BJ, Heineman MJ, Vandekerckhove P. Intra-uterine insemination for male subfertility. Cochrane Database Syst Rev. 2007;(4):CD000360. 10.1002/14651858.CD000360.pub4. [DOI] [PubMed] · DOI

Cited by

Sorted by citations

Authors
Immediata, V., Patrizio, P., Parisen Toldin, M. R., Morenghi, E., Ronchetti, C., Cirillo, F., Baggiani, A., Albani, E., & Levi-Setti, P. E.
Affiliations
  • IRCCS Humanitas Research Hospital (IT)
  • Yale University (US)
Corresponding author
Levi-Setti, Paolo Emanuele
ORCID
Venue
Journal of Assisted Reproduction and Genetics
Publisher
Springer Science and Business Media LLC
Published
2020-03-25
Volume
37
Issue
5
Pages
1195-1201
ISSN
  • 0740-7769 (ISSN-L)
  • 1058-0468
  • 1573-7330
DOI
10.1007/s10815-020-01752-3
PMC
PMC7244676
OpenAlex
W3013713001
Cited by
24
References
1
Citations by year
2026: 1 · 2025: 4 · 2024: 5 · 2023: 6 · 2022: 4 · 2021: 3 · 2020: 1
FWCI
3.09
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Assisted Reproduction and Genetics (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
Keywords
intrauterine insemination, controlled ovarian stimulation, gonadotropins, maternal age, day 3 FSH, clinical pregnancy rate, live birth rate, sperm motility, sperm morphology, body mass index, smoking, infertility duration, twin pregnancy, cumulative live birth rate
MeSH terms
Adult, Female, Fertilization in Vitro, Gonadotropins, Ovarian Follicle, Humans, Infertility, Female, Insemination, Artificial, Male, Maternal Age, Ovulation Induction, Pregnancy, Prognosis, Spermatozoa, Pregnancy Rate, Live Birth

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