Improved pregnancy rate with administration of hCG after intrauterine insemination: a pilot study.
BACKGROUND
In natural cycles, women conceive when intercourse takes place during a six-day period ending on the day of ovulation. The current practice in intrauterine insemination (IUI) cycles is to perform the IUI 24-36 hours after the hCG administration, when the ovulation is already imminent. In this study hCG was administered after the IUI, which more closely resembles the fertilisation process in natural cycles.


METHODS
All the IUIs performed since the beginning of 2007 were analysed retrospectively. Our standard protocol has been to perform the IUI 24-32 hours after hCG administration. From the end of 2008, we started to inject hCG after the IUI at random. The main outcome measure was the result of a urinary pregnancy test. Generalized Estimating Equations (GEE) was used to identify independent factors affecting the cycle outcome.


RESULTS
The analysis included 228 cycles with hCG administered before and 104 cycles hCG administered after the IUI. The pregnancy rates were 10.9% and 19.6% (P = 0.040), respectively. Independent factors (OR, 95% CI) affecting the cycle outcome were sperm count (2.65, 1.20-5.81), number of follicles > 16 mm at IUI (2.01, 1.07-3.81) and the time of hCG administration (2.21, 1.16-4.19).


CONCLUSIONS
Improved pregnancy rate was observed with administration of hCG after IUI.
Järvelä
Ilkka Y
IY
Department of Obstetrics and Gynaecology, Oulu University Hospital, Oulu, Finland. ilkka.jarvela@oulu.fi
Tapanainen
Juha S
JS
Martikainen
Hannu
H
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007315:Insemination, Artificial / Q000379:methods*; D008297:Male; D008962:Models, Theoretical; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013997:Time Factors; D014599:Uterus / Q000187:drug effects / Q000502:physiology; D055815:Young Adult
D006063:Chorionic Gonadotropin