Younger Women with Ovulation Disorders and Unexplained Infertility Predict a Higher Success Rate in Superovulation (SO) Intrauterine Insemination (IUI)
Open accessAbstract
Introduction: Superovulation-intrauterine insemination (SO-IUI) is the most common assisted reproductive technique (ART) in the world, with good evidence of efficacy and cost-effectiveness. However, parameters affecting its success have not been consistently reported. So in this study, we aim at determining the parameters influencing the success rate of SO-IUI. Materials and Methods: We conducted a retrospective cohort study of 797 SO-IUI cycles from 606 patients, performed between 2007 and 2009 in a single centre. These women received clomiphene citrate (CC), recombinant FSH (rFSH) or both. Results: There were 127 clinical pregnancies with a pregnancy rate (PR) of 15.9% (127/797) per treatment cycle. Factors associated with higher PR included maternal age <38 (P = 0.02), subfertility diagnoses of ovulatory disorders, unexplained infertility, sexual dysfunction and unilateral tubal obstruction (P = 0.02), an endometrial thickness ≥8 mm (P = 0.03), total number motile spermatozoa (TNMS) of ≥1 million (P = 0.03), and spermatozoa normal forms (NF) ≥4% (P <0.01) on bivariate analysis. When CC is used, the endometrial thickness is more likely to be suboptimal (<8 mm). All the above parameters remained significant except the subfertility diagnoses on multivariate analysis. Conclusion: Patients’ selection with women <38 years old and preferably with ovulation disorders and unexplained infertility is associated with the highest PR in SO-IUI. Cycle parameters such as the use of rFSH alone, with the avoidance of CC, TNMS ≥1 million and NF ≥4% is likely to result in the best outcomes and reduce the high order multiple pregnancy risk. Key words: Assisted reproductive technique, Fertility, Ovulation disorder, Predictive factors
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Other smaller studies observed that sperm morphology affected the outcome of IUI.
“Other studies of smaller series also observed that sperm morphology affected the outcome of IUI [86, 87, 88, 89, 90, 91, 92, 93].”
From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [93]
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- Authors
- Viardot-Foucault, V., Tai, B. C., Prasath, E. B., Lau, M. S., Chan, J. K., & Loh, S. F.
- Affiliations
- KK Women’s and Children’s Hospital, Singapore
- National University of Singapore (SG)
- KK Women's and Children's Hospital (SG)
- ORCID
- Tai, Bee Choo
- Venue
- Annals of the Academy of Medicine, Singapore
- Publisher
- Academy of Medicine, Singapore
- Published
- 2014-04-15
- Volume
- 43
- Issue
- 4
- Pages
- 225-231
- ISSN
- 0304-4602 (ISSN-L)
- OpenAlex
- W4297625882
- Cited by
- 4
- References
- 27
- Citations by year
- 2025: 1 · 2021: 1 · 2020: 1 · 2018: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of the Academy of Medicine Singapore (publishedVersion)
- PubMed (publishedVersion)
- PubMed
- Funders
- Medical Research Council
- National Medical Research Council (CSA/012/2009)
- 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
- superovulation, intrauterine insemination, ovulatory dysfunction, unexplained infertility, pregnancy rate, maternal age, clomiphene citrate, recombinant FSH, endometrial thickness, sperm motility, sperm morphology, sexual dysfunction, multiple pregnancy risk, patient selection
- MeSH terms
- Adult, Age Factors, Clomiphene, Female, Fertility Agents, Female, Humans, Infertility, Female, Insemination, Artificial, Pregnancy, Prognosis, Retrospective Studies, Superovulation, Cohort Studies, Pregnancy Rate
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