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Effect of follicular diameter at the time of ovulation triggering on pregnancy outcomes during intrauterine insemination
Author(s) -
Maher Mohammad A.,
Abdelaziz Ahmed,
Shehata Yasser A.
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12291
Subject(s) - medicine , pregnancy , ovulation , follicle , infertility , gynecology , obstetrics , pregnancy rate , follicular phase , unexplained infertility , gonadotropin , confidence interval , insemination , fertility , artificial insemination , andrology , population , hormone , endocrinology , sperm , biology , genetics , environmental health
Objective To compare pregnancy outcomes when triggering ovulation at different follicle sizes during intrauterine insemination ( IUI ) cycles. Methods A prospective observational study was undertaken at two collaborative fertility centers in Saudi Arabia between January 2014 and May 2016. Women of any age were enrolled if they met inclusion criteria: primary, secondary, or unexplained infertility (≥1 year); day‐2 follicle‐stimulating hormone less than 12 IU / mL ; normal prolactin, thyroid function, and uterine cavity; at least one patent tube; and a male partner with normal semen count and motility. IUI cycles were subdivided by size of dominant follicle (17 to <18 mm, 18 to <19 mm, 19 to <20 mm, and ≥20 mm), and pregnancy outcomes compared. Results Data from 516 IUI cycles were analyzed. Frequencies of clinical pregnancy, ongoing pregnancy, and live birth for a follicle size of 19–20 mm were 30.2% (39/129), 24.0% (31/129), and 24.0% (31/129), respectively; these rates were significantly higher than those in other groups (all P< 0.05). Only endometrial thickness was found to also contribute to outcome: probability of pregnancy increased as thickness rose (odds ratio 1.148, 95% confidence interval 1.065–1.237; P< 0.001). Conclusion The optimal follicular diameter associated with increased pregnancy rates in gonadotropin‐stimulated IUI cycles was between 19 and 20 mm.