title: Factors Leading to Pregnancies in Stimulated Intrauterine Insemination Cycles and the Use of Consecutive Ejaculations Within a Small Clinic Environment.
abstract: BACKGROUND
  Understanding and improving IUI pregnancy rates has enormous global appeal and application. This pilot study goes one step further by utilising consecutive ejaculates from men with oligozoospermia and comparing with normozoospermic male group.
  
  
  METHODS
  A retrospective analysis was performed on 117 IUI-stimulated treatment cycles in a small fertility clinic in North Middlesex University Hospitals Trust, UK, within a NHS setting. Risks of OHSS and multiple births are carefully controlled.
  
  
  RESULTS
  In our cohort, several factors are associated with positive IUI pregnancies and these were: age of the woman, inseminating with ≥5 total progressive motile sperm; having ≥50 % Grade A sperm progression and having ≥1 follicle achieved with a realistic hMG dosage, hCG trigger and IUI of 29.7 h (2.5-38.4 h), with an endometrial thickness of 10.7 mm (6.6-13.4 mm). Bifollicular presence in at least half the cases along with hMG protocols added usefully to the pregnancy outcomes.
  
  
  CONCLUSIONS
  The pregnancy rates per cycle were 19 and 23 % in the consecutive ejaculates and non-consecutive ejaculate groups, respectively, P = 0.59. For the whole cohort, the pregnancy rate was 20.51 % per cycle and 33.8 % per women. This approach if validated with large RCT will have universally beneficial effects.
authors.affiliation: Reproductive Medicine Unit, North Middlesex University Hospital, Old Admin Block, Sterling Way, London, N18 1QX UK.
authors.forename: Gulam
authors.initials: G
authors.lastname: Bahadur
authors.affiliation: Reproductive Medicine Unit, North Middlesex University Hospital, Old Admin Block, Sterling Way, London, N18 1QX UK.
authors.forename: Ofran
authors.initials: O
authors.lastname: Almossawi
authors.affiliation: Reproductive Medicine Unit, North Middlesex University Hospital, Old Admin Block, Sterling Way, London, N18 1QX UK.
authors.forename: Afeeza
authors.initials: A
authors.lastname: IIlahibuccus
authors.affiliation: Reproductive Medicine Unit, North Middlesex University Hospital, Old Admin Block, Sterling Way, London, N18 1QX UK.
authors.forename: Ansam
authors.initials: A
authors.lastname: Al-Habib
authors.affiliation: Reproductive Medicine Unit, North Middlesex University Hospital, Old Admin Block, Sterling Way, London, N18 1QX UK.
authors.forename: Stanley
authors.initials: S
authors.lastname: Okolo
keywords: Consecutive ejaculates; Gonadotrophin; Intrauterine insemination; Male factor infertility; Total progressive motile sperm