Journal Name:
- International Journal of Medical Research & Health Sciences
Key Words:
| Author Name | University of Author |
|---|---|
Abstract (2. Language):
Objective:1) To find out efficacy of various ovulation induction protocols in IUI 2) To find out the
efficacy of IUI in treatment of infertility Method: All infertility patients of our OPD underwent a
standard investigation protocol The infertility work-up included patients’ history, physical examination,
conformation of ovulation by follicular monitoring, tubal patency test by diagnostic laparoscopy, and
semen analysis of male partner & PCT. All women underwent a standard treatment protocol that
included either natural cycle or ovulation induction to achieve superovulation by clomiphene citrate
alone, or combined with gonadotrophins. Follicula monitoring using transvaginal sonography was done
from D6-8 onwards and all women were given injection Human chorionic gonadotrophin 5000 U for
LH surge when the dominant follicle was ≥18 mm. IUI was Performed at 18 hours and 40 hours from the
time of HCG injection. Semen for IUI was prepared by the standard Swim Up technique, or by the
Density Gradient method. Progesterone (Transvaginal micronized progesterone 200mg/day) for luteal
phase support for 14 days following IUI was given to patients who were affording. Results: Majority of
couples were having primary infertility (60.97%) Patients of secondary infertility were of 39.03% only.
In our study only 11.82% patients were having multiple factors contributing to infertility. Male factor
was in 42.59% of couples as against 30.34% of couples were having only anovulation as causative factor
for infertility. Unexplained infertility was present in 13.82% patients only. The outcome variable for
success of IUI was occurrence of pregnancy. This was defined by delay in menses associated with
presence of positive pregnancy test or a detectable rise in serum beta HCG levels. In our study overall
pregnancy rate per cycle was 8.01% & per couple it was 21.65%. Per cycle fecundity according to the
factor responsible for infertility, the highest success rate was observed in cervical factor (33.33%). For
male factor it was 7.74% and for combined factors overall it was 5.92%. Out of 152 pregnancies that
occurred during study 108 had Full Term live birth of the baby (71.05% Miscarriage was there in 9.87%
patients only. Only three patients had multiple pregnancies (1.97%) and one patient had ectopic
pregnancy. Per cycle fecundity was little better in patients with only anovulation( 10.51%). When we
compared various regimen used for ovulation induction for IUI we found that though percentage of
pregnancies achieved by Low dose HMG either with (13.89%) or without Clomiohene (15.58%),
pregnancy rate achieved with clomiphene alone was 7.43% . This was promising at low affordable cost.In our study, we achieved 40.13% pregnancy with second attempt and collectively with first two
attempts pregnancy rate achieved was 71.71%.
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