Clinical Pregnancy Rate in Intrauterine Insemination and Associated Prognostic Factors

Abstract Background: Intrauterine insemination (IUI) is a popular method for the treatment of infertility, however, its success rate ranges from 7 to 13% in a cycle. Aim: The present study was carried out to assess the IUI success rate and its predictors. Method: A prospective observational study was conducted, and 167 women (aged 21-49 years) with primary or secondary infertility were enrolled to undergo intrauterine insemination. The induction of ovulation for IUI was performed according to the standard protocols. Stimulation was done with letrozole/clomiphene/ FSH/HMG or a combination of these drugs. Human Chorionic Gonadotropin (hCG) was administered at achievement of follicular size 17-18 mm. IUI was done 36–40 hours after the hCG trigger. The luteal phase was supplemented wherever needed. A positive urine pregnancy test (UPT) done 2 weeks after IUI was considered as the primary outcome. Predictors of UPT success were evaluated using Chi-square and Independent Samples t-tests. Results: The mean age of women was 30.58±(SD)4.43 years. The mean duration of infertility was 4±2.65 years. Majority (77.6%) had primary infertility. UPT positivity rate was 18.2% in <30 years and 21.3% in 30 to 45 years and no positive pregnancy in > 45 years. No significant association of age, BMI, level of physical activity, fertility type, ovulation induction frequency, AMH, sperm count, and HSG was seen with outcome (p>0.05). A significant association of outcome with endometrial thickness was observed( p-value 0.001). Conclusion: The IUI success rate was 18.8%. The endometrial thickness was significant predictors of IUI.