title: Predictors of pregnancy and live-birth in couples with unexplained infertility after ovarian stimulation-intrauterine insemination.
abstract: OBJECTIVE
  To identify baseline characteristics of couples that are likely to predict conception, clinical pregnancy, and live birth after up to four cycles of ovarian stimulation with IUI in couples with unexplained infertility.
  
  
  METHODS
  Secondary analyses of data from a prospective, randomized, multicenter clinical trial investigating pregnancy, live birth, and multiple pregnancy rates after ovarian stimulation-IUI with clomiphene citrate, letrozole, or gonadotropins.
  
  
  METHODS
  Outpatient clinical units.
  
  
  METHODS
  Nine-hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation clinical trial.
  
  
  METHODS
  As part of the clinical trial, treatment was randomized equally to one of three arms and continued for up to four cycles or until pregnancy was achieved.
  
  
  METHODS
  Conception, clinical pregnancy, and live-birth rates.
  
  
  RESULTS
  In a multivariable logistic regression analysis, after adjustment for other covariates, age, waist circumference, income level, duration of infertility, and a history of prior pregnancy loss were significantly associated with at least one pregnancy outcome. Other baseline demographic and lifestyle characteristics including smoking, alcohol use, and serum levels of antimüllerian hormone were not significantly associated with pregnancy outcomes.
  
  
  CONCLUSIONS
  While age and duration of infertility were significant predictors of all pregnancy outcomes, many other baseline characteristics were not. The identification of level of income as a significant predictor of outcomes independent of race and education may reflect differences in the underlying etiologies of unexplained infertility or could reveal disparities in access to fertility and/or obstetrical care.
  
  
  BACKGROUND
  NCT01044862.
authors.affiliation: Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Electronic address: karl-hansen@ouhsc.edu.
authors.forename: Karl R
authors.initials: KR
authors.lastname: Hansen
authors.affiliation: Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut.
authors.forename: Amy Linnea W
authors.initials: AL
authors.lastname: He
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts.
authors.forename: Aaron K
authors.initials: AK
authors.lastname: Styer
authors.affiliation: Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Wild
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Samantha
authors.initials: S
authors.lastname: Butts
authors.affiliation: Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, Connecticut.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Engmann
authors.affiliation: Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, Georgia.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Diamond
authors.affiliation: Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey, Pennsylvania.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Legro
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Christos
authors.initials: C
authors.lastname: Coutifaris
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, Colorado.
authors.forename: Ruben
authors.initials: R
authors.lastname: Alvero
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, Texas.
authors.forename: Randal D
authors.initials: RD
authors.lastname: Robinson
authors.affiliation: Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont.
authors.forename: Peter
authors.initials: P
authors.lastname: Casson
authors.affiliation: Department of Obstetrics and Gynecology, Shands Hospital, University of Florida, Gainesville, Florida.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Christman
authors.affiliation: Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut.
authors.forename: Hao
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, Colorado.
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland.
authors.forename: Esther
authors.initials: E
authors.lastname: Eisenberg
authors.affiliation: Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut.
authors.forename: Heping
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D007248:Infertility, Male / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D007315:Insemination, Artificial / Q000379:methods / Q000639:trends*; D050498:Live Birth / Q000453:epidemiology; D008297:Male; D010062:Ovulation Induction / Q000379:methods / Q000639:trends*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011446:Prospective Studies
keywords: Unexplained infertility; intrauterine insemination; ovarian stimulation; predictors; pregnancy