Intrauterine insemination: prognostic factors

Objective: To evaluate the impact of possible maternal and paternal prognostic factors and ovarian stimulation protocols on clinical pregnancy and live birth rates in intrauterine insemination (IUI) cycles. Methods: Retrospective observational study of 341 IUI cycles performed from January 2016 to November 2020 at the Assisted Reproduction Service of the Clinics Hospital of the Ribeir & atilde;o Preto Medical School, University of S & atilde;o Paulo. Clinical pregnancy and live birth rates and their potential prognostic factors were evaluated. Wilcoxon's non -parametric test was used to compare quantitative variables, and the chi-square test to compare qualitative variables, adopting a significance level of p <0.05. A logistic regression model was performed to verify which exploratory variables are predictive factors for pregnancy outcome. Results: The ovulation induction protocol using gonadotropins plus letrozole ( p =0.0097; OR 4.3286, CI 1.3040 - 14.3684) and post -capacitation progressive sperm >= 5million/mL ( p =0.0253) showed a statistically significant correlation with the live birth rate. Female and male age, etiology of infertility, obesity, multifollicular growth, endometrial thickness >= 7 mm, and time between human chorionic gonadotropin administration and IUI performance were not associated with the primary outcomes. In the group of patients with ideal characteristics (women aged< 40 years, BMI < 30 kg/m( 2) , antral follicle count >= 5, partner aged< 45 years, and post -capacitation semen with progressive spermatozoa >= 5 million/mL), the rate of clinical pregnancy was 14.8%, while that of live birth, 9.9%. Conclusions: In this study, the ovulation induction protocol with gonadotropins plus letrozole and postcapacitation progressive sperm >= 5 million/mL were the only variables that significantly correlated with intrauterine insemination success.