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Evaluation of pregnancy rates after intrauterine insemination according to indication, age, and sperm parameters
L A van der Westerlaken1, N Naaktgeboren, F M Helmerhorst
1Department of Reproductive Medicine, University Hospital Leiden, The Netherlands.
Purpose:
Our purpose was to evaluate intrauterine insemination results obtained in our clinic and identify prognostic factors for the chance of pregnancy.
Methods:
A retrospective study of data from 1989 to 1996 was undertaken. Only first attempts were included in this study, except for the part on the cumulative pregnancy rates. Couples with either one-sided tubapathology, hormonal dysfunction, idiopathic infertility, or andrological indication were selected. All women were stimulated with clomiphene citrate. Five hundred sixty-six couples who underwent 1763 cycles were included in the study.
Results:
The overall pregnancy rate for first pregnancies was 6.9% per cycle and 21.4% per patient. For first intrauterine insemination attempts this was 8.8% per cycle/patient, varying between 5.0% for andrological indication and 10.6% for tubapathology, 10.0% for idiopatic indication, and 10.3% for hormonal indication. These differences were not significant. Age did not have a significant effect either, although there were no pregnancies observed in women 40 years or older. The number of inseminated spermatozoa significantly affected the pregnancy rate: < 2 million, 4.6%; > or = 2 to < 10 million, 3.9%; and > or = 10 million, 11.3%.
Conclusions:
Unless semen characteristics are insufficient, intrauterine insemination is a useful treatment for infertile couples.