• Clinical and Experimental Reproductive Medicine
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• 제48권3호
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• pp.255-261
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• 2021

Objective: This study aimed to investigate sperm motility and its changes after preparation as predictors of pregnancy in intrauterine insemination (IUI) cycles. Methods: In total, 297 IUI cycles from January 2012 to December 2017 at a single tertiary hospital were retrospectively analyzed. Patient and cycle characteristics, and sperm motility characteristics before and after processing were compared according to clinical pregnancy or live birth as outcomes. Results: The overall clinical pregnancy rate per cycle was 14.5% (43/297) and the live birth rate was 10.4% (30/289). Patient and cycle characteristics were similar between pregnant and non-pregnant groups. Sperm motility after preparation and the total motile sperm count before and after processing were comparable in terms of pregnancy outcomes. Pre-preparation sperm motility was significantly higher in groups with clinical pregnancy and live birth than in cycles not resulting in pregnancy (71.4%±10.9% vs. 67.2%±11.7%, p=0.020 and 71.6% ±12.6% vs. 67.3%±11.7%, p=0.030, respectively). The change in sperm motility after processing was significantly fewer in the non-pregnant cycles, both when the comparison was conducted by subtraction (post-pre) and division (post/pre). These relationships remained significant after adjusting for the female partner's age, anti-Müllerian hormone level, and number of pre-ovulatory follicles. According to a receiver operating characteristic curve analysis, an initial sperm motility of ≥72.5% was the optimal threshold value for predicting live birth after IUI. Conclusion: Initial sperm motility, rather than the motility of processed sperm or the degree of change after preparation, predicted live birth after IUI procedures.

• Clinical and Experimental Reproductive Medicine
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• 제43권2호
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• pp.102-105
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• 2016

Objective: The goal of this study was to compare the semen parameters of two successive samples obtained within an interval of less than 60 minutes from patients planning to undergo intrauterine insemination (IUI) whose first samples exhibited low semen quality. Methods: Thirty-two consecutive patients were enrolled in the study. On the day of IUI, the semen analysis of the samples initially presented by all patients met at least two of the following criteria: sperm concentration $<5{\times}10^6/mL$, total sperm count $<10{\times}10^6$, progressive sperm motility (a+b) in the native sample <30%, and total motile sperm count (TMSC) $<4{\times}10^6$. A successive semen sample was obtained no more than 60 minutes after the first sample. Results: Compared to the first sample, the second exhibited significantly (p<0.05) improved sperm concentration, TMSC, progressive motility, and vitality. Regarding TMSC, the most critical parameter on the day of IUI, 23 patients (71.8%) improved it, while nine (28.2%) displayed poorer outcomes. Conclusion: In defined cases, requesting a second successive ejaculate on the day of insemination may result in a high percentage of cases in an improvement of the quality of the sample.

• Clinical and Experimental Reproductive Medicine
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• 제25권2호
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• pp.217-231
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• 1998

The effectiveness of intrauterine insemination (IUI) combined with controlled ovanan hyperstimulation (COH) in the treatment of infertility with various etiologies was compared in a total of 152 cycles. Patients received a maximum of three IUI cycles for the treatment. Severe male ($<2\times10^6$ motile sperm) or age factor (> 39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac was seen on ultrasound. The overall clinical pregnancy rate was 7.9% per cycle (12/152) and 9.7% per patient (12/124). The pregnancy rates were 0% in unstimulated natural (0/18), 7.5% in CC (3/40), 8.2% in CC+hMG (4/49), 5.9% in GnRH-a ultrashort (1/17), 5.9% in GnRH-a long (1/17) and 27.3% in dual suppression cycles (3/11), respectively. The pregnancy rate was higher in dual suppression cycle than other stimulated cycles, but this was not significant. The multiple pregnancy rates were 25.0% (2 twins and 1 triplet). No patient developed ovarian hyperstimulation. Abortion rates were 66.7% in CC (2/3) and 100% in ultrashort cycles (1/1). The livebirth rate was 5.9% per cycle (9/152) and 7.3% per patient (9/124). There were no differences in age, duration of infertility, follicle size, total ampules of gonadotropins and days of stimulation between pregnant and non-pregnant groups. However, significant(P<0.05) differences were observed in the level of estradiol $(E_2)$ on the day of hCG injection ($3,266.6{\pm}214.2$ vs $2,202.7{\pm}139.4$ pg/ml) and total motile sperm count ($212.1{\pm}63.4$ vs $105.1{\pm}9.9\times10^6$) between pregnant group and non-pregnant group. These results suggest that IUI combined with successful ovarian stimulation tends to improve the chance of pregnancy as compared to IUI without COH and a total motile sperm count may be considered predictive of the success for pregnancy.

• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.433-440
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• 1999

Objective: To evaluate the effectiveness of CC+FSH or CC+hMG in intrauterine insemination (IUI) cycles for the treatment of infertility. Method: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days followed by hMG or FSH. A single IUI was performed at 36 h after hCG. Clinical pregnancy was classified if a gestational sac or fetal cardiac activity was seen on ultrasound. Results: The overall clinical pregnancy rate was 19.1% per cycle (17/89) and 21.5% per patient (17/79). More clinical pregnancies were recorded in CC+FSH (23.1%, 6/26) than CC+ hMG cycles (17.5%, 11/63), but this difference was not statistically significant. No differences were found in age, duration of infertility, follicle size, levels of estradiol ($E_2$) on the day of hCG injection and total motile sperm counts between pregnant and non-pregnant groups. However, more ampules of gonadotropins were used in pregnant group than non-pregnant group (p<0.05). Conclusion: Combination of CC and hMG may economically be more effective to induce ovulation for IUI compared to CC and FSH.

• Clinical and Experimental Reproductive Medicine
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• 제48권3호
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• pp.198-202
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• 2021

Considerable disagreement exists regarding whether endometrial polyps should be removed before attempting natural pregnancy and before pregnancy via intrauterine insemination (IUI) or in vitro fertilization (IVF). Through a literature review, we obtained information on the impact of endometrial polyps and polypectomy on fertility outcomes. Several observational studies have suggested that women with unexplained infertility may benefit from endometrial polypectomy for a future natural pregnancy. A few studies reported benefits from endometrial polypectomy in infertile women who plan to undergo IUI. However, no strong evidence supports polypectomy as a way to improve the pregnancy rate in infertile women who plan to undergo IVF or polypectomy during controlled ovarian stimulation for IVF. Although no studies have defined criteria for the polyp size that should be removed in infertile women, clinicians should be aware that small endometrial polyps (<10 mm) sometimes regress spontaneously. Endometrial polypectomy is currently justified in patients with repeated IVF failure, but more studies are needed to verify that endometrial polypectomy itself will eventually increase the pregnancy rate. Although several mechanisms by which endometrial polyps exert a negative effect on fertility have emerged, there is no consensus about the proper management of endometrial polyps in infertile women. Therefore, the management of endometrial polyps should be individualized depending on the patient's situation and clinician's preference.

• Clinical and Experimental Reproductive Medicine
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• 제38권1호
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• pp.47-52
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• 2011

Objective: To determine whether characteristics of sperm motility obtained by computer-assisted sperm analysis (CASA) could predict pregnancy after intrauterine insemination (IUI) in couples with unexplained infertility. Methods: Three hundred eighty-three cycles of intrauterine insemination with superovulation were retrospectively analyzed. Semen analysis was performed with CASA before and after swim-up and the parameters were compared between pregnant and non-pregnant women. Results: The pregnancy rate per cycle was 14.1%. Pregnant and non-pregnant women were comparable in terms of age, infertility duration, the number of dominant follicles. While sperm concentration, motility, and parameters such as average path velocity (VAP) and percentage rapid (RAPID) before semen preparation were significantly different between the pregnancy and non-pregnancy groups, there were no differences in sperm parameters when comparing the two groups after preparation. Using a receiver operating characteristic curve to measure sensitivity and specificity, the optimal threshold value for the predictors of pregnancy was revealed to be a concentration of ${\geq}111{\times}10^6/mL$, a motility of ${\geq}$ 51.4%, and RAPID ${\geq}$ 30.1% before preparation for IUI. Conclusion: Sperm parameters including concentration, motility, and RAPID before sperm preparation could have predictive value for pregnancy outcome after intrauterine insemination with superovulation in couples with unexplained infertility, and would be helpful when counseling patients before they make the decision to proceed with IVF/ICSI-ET.

• Clinical and Experimental Reproductive Medicine
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• 제42권4호
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• pp.136-142
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• 2015

Objective: Smoking has been reported to harm nearly every organ of the body, but conflicting results have been reported regarding the effects of smoking on assisted conception. In this prospective cohort study, we aimed to investigate the prevalence of positive urinary cotinine tests in infertile couples and whether cotinine positivity was associated with infertility treatment outcomes. Methods: A qualitative urinary cotinine test was administered to 127 couples who underwent in vitro fertilization (IVF, n=92) or intrauterine insemination (IUI, n=35). Results: The overall prevalence of positive urinary cotinine test was 43.3% (55/127) in the male partners and 10.2% (13/127) in the female partners with similar prevalence rates in both genders in the IUI and IVF groups. Semen characteristics, serum markers of ovarian reserve, and number of retrieved oocytes were comparable among cotinine-positive and cotinine-negative men or women (with the exception of sperm count, which was higher among cotinine-positive men). The results of urinary cotinine tests in infertile couples were not associated with IVF and IUI outcomes. Conclusion: The presence of cotinine in the system, as indicated by a positive urinary cotinine test, was not associated with poorer outcomes of infertility treatment.

• Journal of Korean Biological Nursing Science
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• 제22권3호
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• pp.176-183
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• 2020

Purpose: : The purpose of this study was to evaluate the intrauterine insemination (IUI) success rate and to define the variables for predicting success. Methods: The secondary data analysis was used with data collected from infertile females who underwent IUI in Fertility and IVF (In Vitro Fertilization) clinics, who benefited from the 'National Medical-aid Program for ART (assisted reproductive technology) in 2016', in which the data of 34,920 IUI cases were retrospectively reviewed. The primary outcome measure was the clinical pregnancy rate in elderly and young infertile females. Data were analyzed by descriptive statistics, χ2 test and logistic regression. Results: The pregnancy rate was 12.1% (2,095 cases) in elderly infertile females and 15.6% in young infertile females (2,758 cases) (χ2 = 87.90, p< .001). Using the logistic regression analysis, clinical pregnancy was positively associated with the ovulatory factor (OR= 1.48, p< .001) and male factor (OR= 1.19, p< .05) in elderly infertile females. It was positively associated with the ovulatory factor (OR= 1.30, p= .001) and the peritoneal cavity factor (OR= 0.58, p< .05) in young infertile females. Conclusion: Our results indicate that the pregnancy rate in young infertile females was higher than that in old infertile females, and the IUI is the effective option in pregnancies in all ages with infertility due to the ovulatory factor. Additionally, further studies are necessary to fully describe pregnancy experiences for all the infertile females.

• 한국수정란이식학회지
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• 제17권1호
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• pp.7-12
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• 2002

본 연구는 2001년 5월과 7월에 순천지역의 한 농장을 대상으로 종모돈 64두와 미국의 SGI회사로부터 직수입된 동결정액을 가지고 인공수정시 정액의 형태와 방법이 종모돈의 번식성적에 미치는 영향을 구명하고자 실시한 바, 그 얻어진 결과는 다음과 같았다. 1. 일반적인 액상정액을 이용한 인공수정과 자궁내 이식기구를 이용한 동결정액의 이용이 번식성적에 미치는 영향을 조사한 결과는, 분만율에서는 액상정액을 이용한 처리구 (86.4%)가 동결정액을 이용한 처리구 (67%)보다 높게 나타났다. 산자수와 이유두수는 동결정액을 이용한 처리구 (9.7 및 9두)가 액상정액을 이용한 처리구 (9.29 및 8.8두)보다 높은 수치를 보였으나 유의적인 차이는 없었다. 2. 동결정액을 모돈의 산차별로 구분하고 인공수정하여 얻은 분만율에서는 3∼5산차에서 6두를 공시하여 6두 모두 임신에 성공하여 100%의 분만율을 보였으나, 6∼10산차에서는 4두를 공시하여 1두만이 분만되었다. 그리고 산자 수와 이유두수에서 0∼2산차 (11.3 및 9.3두), 6 ∼ 10산차 (8 및 8두)로 산차가 높을수록 전체적인 번식성적이 낮아지는 수치를 보였으나 유의적인 차이는 없었다. 이상의 결과에서 동결정액을 이용한 인공수정시 자궁심부까지 주입하는 자궁내 인공수정 기술을 이용함으로 임신율과 산자수수 및 이유 두수에서 신선정액을 자궁경관에 주입하는 인공수정방법과 유의차를 보이지 않았을 뿐만 아니라 대등한 결과를 얻을 수 있었다. 동결정액은 자궁내 인공수정기술 방법과 함께 이용 할 수 있는 그 가능성을 제시할 수 있다고 판단되었다.

• Clinical and Experimental Reproductive Medicine
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• 제34권1호
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• pp.33-39
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• 2007

목 적: 자궁강 내 인공수정을 위한 과배란유도 시 혈청 vascular endothelial growth factor (VEGF) 농도가 과배란유도의 결과를 반영할 수 있는지를 확인해 보고자 하였다. 연구방법: 과배란유도 후 자궁강 내 인공수정을 시행 받은 49 명의 불임여성을 대상으로 hCG 투여 일에 혈청을 얻어 VEGF-A 및 estradiol 농도를 측정하였다. 과배란유도는 clomiphene citrate (100 mg/d on day 3$\sim$7) 와 human menopausal gonadotropin (150 IU every other day starting on day 5) 병합요법을 이용하였다. hCG 투여 일에 17mm 이상의 성숙난포 수와 자궁내막 두께를 동시에 측정하였다. 결 과: 혈청 VEGF-A 농도는 성숙난포 수, estradiol 농도 및 자궁내막 두께와는 무관하였던 반면 성숙난포 수와 estradiol 농도는 양의 비례관계를 보였다. 혈청 VEGF-A 농도는 성숙난포 수가 2 개 이하인 저 반응 군과 6 개 이상인 고 반응 군에서 통계적으로 유의하지는 않지만 낮은 수치를 보였다. 결 론: 혈청 VEGF-A 농도는 자궁강 내 인공수정 시술 시 과배란유도의 결과와 무관한 것으로 사료되지만 저 반응 군과 고 반응 군에서 낮은 농도를 보이는 것으로 보아 이들을 대상으로 한 추가 연구가 필요할 것으로 판단된다.