title: Risk factors for multiple gestation in women undergoing intrauterine insemination with ovarian stimulation.
abstract: OBJECTIVE
  To identify whether sperm characteristics after washing and/or ovulation induction cycle characteristics can predict the occurrence of multiple conception in patients undergoing ovarian stimulation and IUI.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  A gynecology clinic and an andrology laboratory at a tertiary care facility.
  
  
  METHODS
  One hundred patients with single pregnancies and 22 patients with multiple pregnancies.
  
  
  METHODS
  Patients underwent ovarian stimulation and IUI with their partner's sperm.
  
  
  METHODS
  Relation of patient characteristics, ovarian stimulation, and sperm characteristics after washing to the occurrence of multiple pregnancy.
  
  
  RESULTS
  The mean serum E2 level on the day of hCG injection was significantly higher in the multiple conception group, but the number of follicles was not. The total sperm count, total motile sperm count, and sperm motility after washing did not differ between the groups. However, couples with multiple pregnancies had sperm with a significantly higher amplitude of lateral head movement than couples with single pregnancies. A peak E2 level of >583 pg/mL on the day of hCG injection and sperm with an ALH of >4 microm after washing predicted the occurrence of multiple pregnancy.
  
  
  CONCLUSIONS
  Sperm with an amplitude of lateral head movement of >4 microm and a peak E2 level of >583 pg/mL are significant risk factors for multiple pregnancy in patients undergoing IUI.
authors.affiliation: The Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: E B
authors.initials: EB
authors.lastname: Pasqualotto
authors.forename: T
authors.initials: T
authors.lastname: Falcone
authors.forename: J M
authors.initials: JM
authors.lastname: Goldberg
authors.forename: C
authors.initials: C
authors.lastname: Petrauskis
authors.forename: D R
authors.initials: DR
authors.lastname: Nelson
authors.forename: A
authors.initials: A
authors.lastname: Agarwal
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D002996:Clomiphene / Q000627:therapeutic use; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D007317:Insemination, Artificial, Homologous; D008297:Male; D008596:Menotropins / Q000627:therapeutic use; D015999:Multivariate Analysis; D010053:Ovary / Q000187:drug effects / Q000502:physiology*; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D012307:Risk Factors; D012661:Semen / Q000502:physiology; D013077:Sperm Head / Q000502:physiology; D013081:Sperm Motility / Q000502:physiology
chemical_list: D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D002996:Clomiphene; D004958:Estradiol; D008596:Menotropins