Should Ovulation Induction/Intrauterine Insemination Be Offered to Women With Tubal Factor Infertility? [24G]

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Abstract

INTRODUCTION:

The purpose of this study is to evaluate the outcomes of ovulation induction/intrauterine insemination (OI/IUI) in patients with tubal factor infertility (TFI) and at least one patent fallopian tube compared to patients with idiopathic infertility (II).

METHODS:

Design: Retrospective. Setting: Academic fertility center. Patients/Interventions: Data from 630 OI/IUI cycles were analyzed. Cycle outcomes of patients with TFI (125 cycles) were compared to those of an age-matched control group (1:3) of women with II (505 cycles). Outcome measures: Clinical pregnancy (CPR), ectopic pregnancy (ectPR), spontaneous abortion (SABR) rates per cycle, and cumulative clinical pregnancy rates (cumCPR). Statistics: t tests and chi-square, as appropriate.

RESULTS:

The groups did not differ in age, BMI, day-3 FSH, peak E2, day of hCG trigger, or total motile sperm count (mean±SD 34.2±3.8 vs 34.4±3.8 years, P=.81; 24.1±4.1 vs 24.1±4.4 kg/m2, P=1.00; 7.1±2.0 vs 6.8±2.2IU, P=.44; 464.2±222.8 vs 562.8±287.5 pg/mL, P=.25; 11.3±2.3 vs 10.9±2.2, P=.07; 66.1±59.5 vs 60.6±71.2 million, P=.48; for TFI vs II, respectively). However, TFI patients required a higher total gonadotropin dose compared to women with II (720.5±531.2 vs 579.388.2±388.2 IU, P=.005, respectively). CPR, cumCPR, and SABR were comparable between groups (8.9% vs 11.4%, P=.52; 25.9% vs 34.7%, P=.25; 21.4% vs 18.8%, P=1.00, for TFI vs II, respectively). A higher ectPR was noted among TFI patients (2/14 vs 1/64, P=.08, respectively), though the difference did not reach statistical significance.

CONCLUSION:

OI/IUI should be considered in patients with TFI with at least one patent fallopian tube, since cycle outcomes do not differ significantly from those of women with II undergoing the same type of treatment.

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