Analysis of Clinical and Spermatic Factors on Pregnancy Rate of Intrauterine Insemination

doi:10.3877/cma.j.issn.1673-5250.2013.04.011

Objective

To evaluate the effect-relative factors on pregnancy rate after intrauterine insemination (IUI) by analyzing the clinical data of patients receiving IUI with husband sperm.

Methods

Clinical data of 213 infertile couples who received IUI in Yunnan Population and Family Planning Research Institute from January 2009 to September 2011 were selected, and 298 cycles were included. This study followed the ethical standards which formulated by Yunnan Population and Family Planning Research Institute, approved by the committee. The relationship between clinical factors, including maternal age, infertile time, infertile type, ovulation induction protocol, processed total motile sperm count(PTMS) and pregnancy rate were analyzed.

Results

The pregnancy rate in the group of <30, 30-34 and 35-39 were not significant (χ²=4.58, P>0.05). The pregnancy rate of the patients ≥40 years old decreased significantly (χ²=179, P<0.05). The pregnancy rate of the patients with infertile time≥5 years was more higher than that of infertile time <2 years and 3-4 years (χ²=298, P<0.05). The pregnancy rate of the patients with secondary infertility was significantly higher than that of the patients with primary infertility (χ²=578, P<0.05). The pregnancy rate in the groups of PTMS <5×10⁶/mL, (5-10)×10⁶/mL, >10×10⁶/mL were significantly difference (χ²=596, P<0.05).

Conclusions

In the course of IUI with husband sperm, female age, infertile time, primary or secondary infertility, ovulation induction protocol and PTMS could affect pregnancy rate.

Key words: processed total motile sperm count, intrauterine insemination, pregnancy rate

表1 女方年龄对IUI临床妊娠率的影响

Table 1 The influence of female age on IUI pregnancy rates

年龄(岁)	n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)
<30	33	63	11	17.46
30～34	102	126	19	15.08
35～39	65	91	11	12.08
≥40	13	18	1	5.56

表1 女方年龄对IUI临床妊娠率的影响

Table 1 The influence of female age on IUI pregnancy rates

年龄(岁)	n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)
<30	33	63	11	17.46
30～34	102	126	19	15.08
35～39	65	91	11	12.08
≥40	13	18	1	5.56

表2 不孕年限、类型对IUI临床妊娠率的影响

Table 2 The influence of infertile time and type on IUI pregnancy rates

项目		n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)	χ²	P
不孕类型		?	?	?	?	?	?
?	原发性不孕	115	166	20	12.05	578	0.00
?	继发性不孕	98	132	22	16.67	?	?
不孕年限(年)		?	?	?	?	?	?
?	<2	55	79	14	17.72	298	0.00
?	2～4	94	135	20	14.81	?	?
?	≥5	64	84	8	9.52	?	?

表2 不孕年限、类型对IUI临床妊娠率的影响

Table 2 The influence of infertile time and type on IUI pregnancy rates

项目		n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)	χ²	P
不孕类型		?	?	?	?	?	?
?	原发性不孕	115	166	20	12.05	578	0.00
?	继发性不孕	98	132	22	16.67	?	?
不孕年限(年)		?	?	?	?	?	?
?	<2	55	79	14	17.72	298	0.00
?	2～4	94	135	20	14.81	?	?
?	≥5	64	84	8	9.52	?	?

表3 自然周期与促排卵周期的IUI临床妊娠率比较

Table 3 Comparison between the pregnancy rates of natural cycle and stimulation cycle

方案	n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)	χ²	P
自然周期＋hCG	128	188	24	12.77	5.54	0.136
HMG＋hCG	85	110	18	16.36	?	?

表3 自然周期与促排卵周期的IUI临床妊娠率比较

Table 3 Comparison between the pregnancy rates of natural cycle and stimulation cycle

方案	n	治疗周期数(个)	临床妊娠数(n)	临床妊娠率(%)	χ²	P
自然周期＋hCG	128	188	24	12.77	5.54	0.136
HMG＋hCG	85	110	18	16.36	?	?

表4 PTMS与IUI临床妊娠率的关系

Table 4 The relationship between processed total motile sperm count and IUI pregnancy rates

PTMS(×10⁶/mL)	女方年龄(±s，岁)	不孕年限(±s，年)	治疗周期数(个)	临床妊娠数(个)	周期妊娠率(%)
<5	32.5±4.4	2.9±1.5	56	3	5.36
5～10	34.6±3.8	3.5±2.1	133	22	16.54
>10	31.9±2.4	3.7±2.4	109	17	16.00

表4 PTMS与IUI临床妊娠率的关系

Table 4 The relationship between processed total motile sperm count and IUI pregnancy rates

PTMS(×10⁶/mL)	女方年龄(±s，岁)	不孕年限(±s，年)	治疗周期数(个)	临床妊娠数(个)	周期妊娠率(%)
<5	32.5±4.4	2.9±1.5	56	3	5.36
5～10	34.6±3.8	3.5±2.1	133	22	16.54
>10	31.9±2.4	3.7±2.4	109	17	16.00

1	ESHRE Capri Workshop Group. Intrauterine insemination[J]. Hum Reprod Update, 2009, 15(3): 265-277.
2	Wang B, Hu YL, Sun HX, et al. Investigation of correlative factors affecting successful intrauterine insemination[J]. Chin J Androl, 2004, 10(7): 526-529.
3	Merviel P, Heraud MH, Grenier N, et al. Predictive factors for pregnancy after intrauterine insemination (IUI): An analysis of 1038 cycles and a review of the literature[J]. Fertil Steril, 2010, 93(1): 79-88.
4	Plosker SM, Jacobson WA, Mao P. Predicting and optimizing success in an intrauterine insemination program[J]. Hum Reprod, 1994, 9(11): 2014-2021.
5	Iberico G, Vioque J, Ariza N, et al. Analysis of factors influencing pregnancy rates in homologous intrauterine insemination[J]. Fertil Steril, 2004, 81(5): 1308-1313.
6	Zadehmodarres S, Oladi B, Saeedi S, et al. Intrauterine insemination with husband semen: An evaluation of pregnancy rate and factors affecting outcome[J]. J Assist Reprod Genet, 2009, 26(1): 7-11.
7	Bensdorp AJ, Cohlen BJ, Heineman MJ, et al. Intra-uterine insemination for male subfertility[J]. Cochrane Database Syst Rev, 2007, 17(4): CD000360.
8	Ferrara I, Balet R, Grudzinskas JG. Intrauterine insemination with frozen donor sperm pregnancy outcome in relation to age and ovarian stimulation regime[J]. Hum Reprod, 2002, 17(9): 2320-2324.
9	Zhu WB, Fan LQ, Zheng YR, et al. Effect of different time of insemination and number of motile sperm on IUI pregnancy rate[J]. Chin J Androl, 2003, 17(2)：110-112.
10	Lu SM, Zhao LX, Chen ZJ, et al. The effect of sperm parameters on pregnancy outcome after intrauterinein semination[J]. Chin J Androl, 2006, 20(1): 32-34.
11	Cheng J, Zhang LJ, Su H. Analysis of the male factors impacting to pregnancy rate of intrauterine insemination with husband's semen[J]. Chin J Birth Health Hered, 2011, 19(3): 99-102.
12	Badawy A, Elnashar A, Eltotongy M. Effect of sperm morphology and number on success of intrauterine insemination[J]. Fertil Steril, 2009, 91(3): 777-781.

[1]	Wei Shi, Xiaoyu Niu, Yueyue Chen, Dongmei Wei, Xiaojuan Yu, Zhongying Huang, Jie Yang, Zhihan Zhang. Pelvic floor neuromuscular electrical stimulation in treatment of patients with thin endometrium[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2021, 17(02): 215-220.
[2]	Luhua Yu, Lin Liu, Yu Pan, Xiaoqin Lyu, Xiao He, Li Wang, Xiaomei Zhang. Effects of age of infertile female and her level of serum basal follicle stimulating hormone on pregnancy outcome of artificial insemination with husband′s sperm[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2019, 15(02): 186-191.
[3]	Qingqing Sun, Yijuan Cao, Juan Gu, Yujuan Qi, Qianqian Yin. Clinical analysis of treatment of infertility caused by hydrosalpinx[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2019, 15(01): 81-85.
[4]	Lin Xu, Luhua Yu, Xueli Li, Xiaomei Zhang. Influence of body mass index on pregnancy outcomes of women underwent artificial insemination by husband[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2018, 14(01): 92-98.
[5]	Fang Lyu, Luhua Yu, Liping Wang, Xueli Li, Lin Xu, Fang Chen, Chunhui Zhu, Kaifeng Liu, Chenwang Zhang, Li Wang, Xiaomei Zhang. Outcomes of different times of vitrification-thawed embryo transfer in freeze-all cycles paitents[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2017, 13(05): 569-573.
[6]	Meiyan Cai, Xiaoling Sun. Influences of bed rest time after in vitro fertilization-embryo transfer on pregnancy outcomes[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2017, 13(01): 84-87.
[7]	Haiquan Luo. Clinical effect analysis of embryo intervention, treatment of laparoscopy and transvaginal uterine in patients with cesarean scar pregnancy[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2016, 12(06): 667-671.
[8]	Quan Wang, Yingmei Zhou, Ying He. Clinical significance of expression of p27 and cyclin E in endometriosis[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(06): 546-552.

Viewed

Full text

Abstract

Please choose a citation manager

Content to export