Effect of ovulation before or after intrauterine insemination on pregnancy outcome in patients with unexplained infertility or polycystic ovarian syndrome

Abstract

Objective

To investigate the relationship between ovulation and pregnancy outcomes in patients undergoing intrauterine insemination (IUI).

Methods

The clinical data from 784 patients, diagnosed with polycystic ovarian syndrome (PCOS) or unexplained infertility, underwent 1624 IUI cycles were analyzed retrospectively. Ovulation was observed by transvaginal ultrasonography on the day of IUI. The clinical pregnancy rate (CPR), abortion rate (AR), and live birth rate (LBR) were analyzed.

Results

The study included 1031 pre-ovulation IUI cycles (63.49%) and 593 post-ovulation IUI cycles (36.51%). The CPR was 13.05%, the AR was 15.57%, and the LBR was 11.02%. Ovulation before or after IUI affected the CPR (11.06% VS 16.53%, p = .002) and LBR (9.41% VS 13.83%, p = .006) per cycle, but did not affect the AR (14.91% VS 16.33%, p = .149). The sex ratio of children was not related to ovulation (p = .948). After adjusting for baseline characteristics and logistic regression, the CPR (OR = 1.931, 95% CI 1.062–1.931, p = .019) and LBR (OR = 1.389, 95% CI 1.007–1.916, p = .045) of post-ovulation insemination were higher than those of pre-ovulation insemination significantly.

Conclusion

Pregnancy outcomes were affected by ovulation on the day of IUI in patients with unexplained infertility or PCOS. Post-ovulation insemination may improve the CPR of IUI.

摘要

目的

探讨宫腔内人工授精(IUI)患者排卵与妊娠结局的关系。

方法

回顾性分析784例多囊卵巢综合征(PCOS)或不明原因不孕症患者1624个IUI周期的临床资料。于IUI当天行经阴道超声检查观察排卵情况。分析临床妊娠率(CPR)、流产率(AR)、活产率(LBR)。

结果

排卵前IUI周期1031例（63.49%）,排卵后IUI周期593例（36.51%）。 CPR为13.05%, AR为15.57%, LBR为11.02%。 IUI前后排卵对每个周期的CPR(11.06%vs16.53%, P=0.002)和LBR(9.41%vs13.83%, P=0.006)均有影响, 但对AR(14.91%vs16.33%, P=0.149)无影响。 婴儿性别比例与排卵是否无关(P=.948)。校正基线特征和logistic回归后, 排卵后人工授精的CPR(OR=1.931,95%CI1.062-1.931,P=0.019)和LBR(OR=1.389,95%CI1.007-1.916,P=0.045)显著高于排卵前人工授精。

结论

不明原因不孕或多囊卵巢综合征患者IUI当天排卵情况影响妊娠结局。排卵后人工授精可改善IUI的临床妊娠率。

Keywords:

• Clinical pregnancy rate
• ovulation
• intrauterine insemination
• polycystic ovarian syndrome
• body mass index

关键词:

• 临床妊娠率
• 排卵
• 宫腔内人工授精
• 多囊卵巢综合征
• 体重指数

Author contributions

Lisha Tang designed research, Hang Song and Huijuan Guan collected the data, Huaiyun Tang directed the writing of the paper, Hang Song analyzed data and wrote the paper.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical statement

The ethics committee approved this study of the Lianyungang Maternal and Child Health Hospital. All patients have signed informed consent on obtaining and analyzing their clinical data before the initiation of IUI treatment.

Additional information

Funding

This work was supported by grants from Jiangsu Commission of Health (H2018014), 521 projects of Lianyungang city (LYG52105-2018080) and Youth Fund projects of Lianyungang maternal and Child Health Hospital (KY202104).