Clinical effect and influencing factors of pregnancy after intrauterine insemination with the husband′s sperm in 2 140 cases of infertile women

ZHU Juan; MA Yanlin; HUANG Yuanhua; LU Weiying; ZHANG Yi; HUANG Wei; LI Qi; YANG Zaijia

doi:10.3969/j.issn.1002-266X.2017.19.001

Abstract：Objective To observe the clinical effect of intrauterine insemination (IUI) with the husband′s sperm on pregnancy in 2 140 cases of infertile women, and to analyze its influencing factors.Methods Totally 2 140 cases of infertility women treated with IUI for 3 383 ovulation-promoting cycles of intrauterine insemination with the husband′s sperm were retrospectively analyzed.We used B ultrasound to calculated HCG day′s follicles with diameter ≥14 mm and to measure the endometrial thickness.Thirty days after IUI, the clinical pregnancy rate, delivery rate, abortion rate, ectopic pregnancy rate, and multiple pregnancy rate were calculated.The correlations between clinical pregnancy rate, delivery rate, and the following factors, including infertile patients′ age, type of infertility, indications, and times of IUI, were analyzed.Results In the 3 383 IUI cycles, the mean number of HCG day′s follicles with diameter ≥14 mm was (2.6±1.9), and the mean endometrial thickness was (9.4±2.0) mm.Thirty days after IUI, the clinical pregnancy rate was 15.0% (508/3 383), and delivery rate was 11.1% (375/3 383).The abortion rate was 16.9% (86/508).Ectopic pregnancy rate was 8.9% (45/508), including 4 cases of heterotopic pregnancy, 58 cases of twin pregnancy, 8 cases of triplet pregnancy, 3 cases of quadruplet pregnancy, and the multiple pregnancy rate was 13.6% (69/508).The group of women with age >40 mm years had significantly lower clinical pregnancy rate and delivery rate than the other groups (all P<0.05).The clinical pregnancy rates of patients with primary and secondary infertility were 14.8% (285/1 921) and 15.3% (223/1 462), and the delivery rates were 10.9% (209/1 921) and 11.4% (166/1 462), respectively (all P>0.05).In 39 to 40 years old women, the delivery rate of patients with primary infertility was significantly lower than that of patients with secondary infertility (P<0.05).The clinical pregnancy rate and the delivery rate in patients with female factor infertility were lower than those in patients with the mixed factors (all P<0.05).There were no statistically differences in clinical pregnancy rate and delivery rate between different IUI cycles.Conclusions The success rate of IUI is still low.For the cases with maternal age <40, increasing the number of IUI cycles is an important factor for improving the outcome of IUI pregnancy.Therefore, the clinical comprehensive analysis of the age, type of infertility, infertility reason should be taken in order to choose appropriate assisted reproduction scheme.