Predictive factors for pregnancy after intrauterine insemination (IUI): An analysis of 1038 cycles and a review of the literature

Objective: To determine the predictive factors for pregnancy after IUI. Design: Retrospective Study. Setting: A single university medical center. Patient(s): One thousand thirty-eight IUI cycles in 353 couples were studied between 2002 and 2005. Intervention(s): Ovarian stimulation via SC injection of FSH or hMG was performed daily; IUI was then performed 36 hours after triggering ovulation if at least one follicle measuring > 16 mm and an endometrial thickness of >7 mm (with triple-line development) were obtained. Main Outcome Measure(s): Clinical pregnancy rates were analyzed according to the woman's age, the type of infertility, the spermogram characteristics, the total motile spermatozoa (TMS) count, the E-2 level before hCG injection, and the number of mature follicles. Result(s): The couple with the best chance of pregnancy can be described as follows: an under 30 woman with cervical or anovulatory infertility and a man with a TMS L 5 million spermatozoa. The "ideal" stimulation cycle enables the recruitment of two follicles measuring > 16 mm with an E-2 concentration >= 500 pg/mL on the day of hCG administration. The best results are obtained when IUI is performed using a soft catheter. Conclusion(s): This study enabled the characterization of many prognostic factors for pregnancy and particularly those for women at risk of multiple pregnancies after IUI. (Fertil Steril(R) 2010;93:79-88. (C)2010 by American Society for Reproductive Medicine.)