Relationship of follicle number, serum estradiol, and other factors to birth rate and multiparity in human menopausal gonadotropin-induced intrauterine insemination cycles

Richard P. Dickey, R P Dickey, Dickey RP, Olar TT, T T Olar, Terry T. Olar, Steven N. Taylor, Taylor SN, S N Taylor, Curole DN, David N. Curole, D N Curole, Rye PH, P H Rye, Phillip H. Rye, Matulich EM, E M Matulich, Ellen M. Matulich
Fertility and Sterility · 1991 · vol. 56(1) , pp. 89–92 · doi:10.1016/s0015-0282(16)54423-9 · PMID:1906021 · W102959407
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This study investigated the association between follicle count, estradiol levels, and other variables with pregnancy and subsequent multiple births in women undergoing intrauterine insemination with human menopausal gonadotropins.

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Abstract

ObjectiveTo determine the characteristics associated with pregnancy and multiple gestation after human menopausal gonadotropin intrauterine insemination (hMG-IUI).DesignProspective study of all patients undergoing hMG-IUI between January 1, 1984 and December 31, 1989.SettingUniversity affiliated private clinic.PatientsFour hundred twenty-four infertility patients undergoing 779 cycles of hMG-IUI.Main outcome measuresThe relationship between estradiol (E2), number and size of follicles, age, and initial semen quality on pregnancy and multiple gestations in hMG-IUI cycles.ResultsThe number of follicles greater than or equal to 12 mm was correlated with births and predicted all multiple births (r = 0.140, P less than 0.001). The corrected birth rate was 25.8% for age less than 35 and 14.0% for age greater than or equal to 35 when four or more follicles were greater than or equal to 12 mm. The uncorrected clinical pregnancy rate (PR) and birth rate were 12.8% and 10.5%, respectively. Decreased births were associated with tubal adhesions alone (P less than 0.03) or with endometriosis (P less than 0.002), more than four cycles of treatment (P = 0.01), initial sperm count less than 5 x 10(6) per mL (P less than 0.01), initial sperm motility less than 30% (P less than 0.002), and age greater than or equal to 35 (P less than 0.01). Estradiol was correlated with birth rate (r = 0.160, P less than 0.001), which increased from 3.6% when E2 was less than 500 pg/mL to 19.6% when E2 was greater than or equal to 2,500 pg/mL.ConclusionsThe outcome of hMG-IUI is related to the number of follicles greater than or equal to 12 mm, to E2, and to age. Optimal PRs from hMG-IUI require mild ovarian hyperstimulation.

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MeSH descriptors

Estradiol Insemination, Artificial Menotropins Ovarian Follicle Pregnancy, Multiple Adult Age Factors Estradiol Female Humans Infertility Infertility Infertility Menotropins Ovarian Follicle Ovulation Induction Pregnancy Prospective Studies

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