Abstract

Objective: The objective of this study is to further examine the effects of basal anti-mullerian hormone (AMH), induction protocols used in Controlled Ovarian Stimulation (COS), age and total motile sperm count (TMSC) on the pregnancy rate obtained through Intrauterine Insemination (IUI).

Materials and Methods: 242 infertile couples were enrolled in our study and the factors affecting the pregnancy rate as a result of IUI treatment were examined retrospectively. The values corresponding to Basal AMH, the age of women, induction protocols used in COS and TMSC of patients who got pregnant and who did not were compared. For COS procedure, CC, Letrozole and additionally gonadotropin was applied in combination with the aforementioned drugs. 17 patients of 242 were inseminated during their natural menstrual cycle. The results are provided in percentages, standard deviation and mean values, furthermore the effects of the examined parameter (mentioned above) on the rate of pregnancy were measured by regression analysis. According to their qualifications, data obtained were compared in Independent T test and Pearson Chi-square test. If the P value is lower than 0,05, statistically it is accepted as significant.

Results: As a result of IUI treatment, in 44 out of 242 patient (18,2%), the pregnancy was obtained. When the mean values of Basal AMH are considered, there were no significant difference between the values for patients who got pregnant and who did not. (Mean ± Standard Deviation for patients who got pregnant and who did not are respectively 2,14 ± 0,93 and 2,11 ± 0,76). There is also no significant difference in the mean values of AMH regarding pregnancy (p = 0,924). During the natural menstrual cycle (n = 17) and in the group treated with Letrozole (n = 5), no pregnancies were observed. The highest rate of pregnancy is observed in the groups treated with Letrozole + HMG (33,3%) and Letrozole + FSH (27,9%). Pregnancy rate is not dependent on the used drug. Between the age of 18-25 in women, the rate of pregnancy is the highest, (30,6%) with older age, the rate of pregnancy decreases. Pregnancy rates were not different in the age groups. In the washed semen used for IUI, the mean value for TMSC was 80,69 million/liter. TMSC value is not significant on the rate of pregnancy (p = 0,635).

Conclusion: The most important factor affecting pregnancy might be the age. Basal AMH and the type and combination of COS drugs and TMSC seem to make no significant difference in IUI treatment. As is IUI treatment is easy and compared to IVF cheaper, yet the field calls for new strategies and researches to increase pregnancy rates.

Keywords: IUI; AMH; COS; IVF

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