Prognostic factors for successful outcome in patients undergoing controlled ovarian stimulation and intrauterine insemination

G Makkar, EHY Ng, WSB Yeung, PC Ho
Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong

OBJECTIVE. To determine the prognostic factors associated with successful outcome following controlled ovarian stimulation and intrauterine insemination.

DESIGN. Retrospective analysis.

SETTING. University-based assisted reproductive technology centre, Hong Kong.

PATIENTS AND METHODS. Patients included 292 couples undergoing 600 treatment cycles, following a standard protocol of human menopausal gonadotrophin injections. Multiple logistic regression analysis was performed to determine which demographic and sperm parameters gave the maximum discrimination to predict pregnancy.

RESULTS. One hundred and eleven pregnancies resulted from treatment. The pregnancy rates were 18.5% per cycle and 37.9% per couple. The age of the women was significantly lower for pregnant cycles, and the serum oestradiol levels and number of follicles greater than 16 mm in diameter were significantly higher, compared with non-pregnant cycles. The sperm concentration and number of motile spermatozoa were also significantly increased in pregnant cycles. Pregnancy rate was significantly increased when the raw semen sample contained 20 million/mL or more spermatozoa, normal forms comprised 7% or more, and when the number of motile spermatozoa in inseminated samples was 1 million or greater.

CONCLUSION. Using multiple logistic regression analysis, age of the women and serum oestradiol level had the maximum power to predict pregnancy following ovarian stimulation and intrauterine insemination.

Hong Kong Med J 2003;9:341-5

Key words: Insenmination; Ovarian stimulation; Prognosis; Semen