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Yun Ye
Zhongshan People's Hospital
Corresponding Author
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Background: Some studies stated that intra-uterine insemination (IUI) with controlled ovarian stimulation (COS) might increase the chance of pregnancy, while others suggested that IUI in natural cycle (NC) should be the treatment of first choice. Whether it is necessary to use COS at the same time, when IUI is applied to treat male infertility solely? There is still no consensus.
Objective: To investigate the efficacy of IUI with COS in male infertility solely?
Methods: 544 IUI cycles from 280 couples who sought medical care for male infertility from January 2010 to February 2019 were divided into two groups: group NC-IUI and group COS-IUI. Besides, the COS-IUI group was further divided into two subgroups according to the number of pre-ovulatory follicles on the day of HCG: cycles with monofollicular development (1 follicle group) and cycles with at least two pre-ovulatory follicles (≥ 2 follicles group). The outcome of IUI, including clinical pregnancy rate, live birth rate, spontaneous abortion rate, ectopic pregnancy rate and multiple pregnancy rate were compared.
Results: The clinical pregnancy rate, live birth rate, early spontaneous abortion rate, and ectopic pregnancy rate were comparable between NC-IUI group and COS-IUI group. Similar results were observed among NC-IUI group, 1 follicle group and ≥ 2 follicles group. However, when it comes to the multiple pregnancy rate, a trend toward higher multiple pregnancy rate was observed in the COS-IUI group compared that in the NC-IUI group (10.5% (2/19) vs. 0 (0/42), P=0.093), furthermore, a significant difference was found between NC-IUI group and ≥ 2 follicles group (0 vs. 20%, P =0.034).
Conclusion: For male infertility, since in cycles with COS, especially in those with at least two pre-ovulatory follicles cycles, the multiple pregnancy rate increased without substantial gain in overall pregnancy rate, COS in IUI should not be recommended. If COS is required, one stimulated follicle and one health baby should be the goal considering the safety both for mothers and fetuses.
Keywords
Intra-uterine insemination, Controlled ovarian stimulation, Clinical pregnancy, Live birth, Multiple pregnancy
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CURRENT STATUS: Published
View the published article at Reproductive Biology and Endocrinology.
No community comments so far
Editorial decision: Minor revision
On 20 Feb, 2021
Review #2 received
Received 17 Feb, 2021
Reviewer #3 agreed
On 14 Feb, 2021
Review #1 received
Received 14 Feb, 2021
Review #3 received
Received 14 Feb, 2021
Reviewer #2 agreed
On 12 Feb, 2021
Reviewers invited
Invitations sent on 11 Feb, 2021
Reviewer #1 agreed
On 11 Feb, 2021
Editor assigned
On 30 Jan, 2021
Submission checks complete
On 30 Jan, 2021
Editor invited
On 30 Jan, 2021
Version 1
Posted 09 Nov, 2020
No comments provided
Editorial decision: Major revision
On 16 Dec, 2020
Review #3 received
Received 15 Dec, 2020
Reviewer #4 agreed
On 07 Dec, 2020
Review #2 received
Received 05 Dec, 2020
Reviewer #3 agreed
On 04 Dec, 2020
Reviewer #2 agreed
On 04 Dec, 2020
Review #1 received
Received 15 Nov, 2020
Reviewer #1 agreed
On 11 Nov, 2020
Reviewers invited
Invitations sent on 10 Nov, 2020
First submitted
On 31 Oct, 2020
Editor assigned
On 31 Oct, 2020
Submission checks complete
On 31 Oct, 2020
Editor invited
On 31 Oct, 2020
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PDF Downloads: ...
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Subject Areas
Endocrinology & Metabolism
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A new preprint design is coming!
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See the published version of this preprint at Reproductive Biology and Endocrinology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Yun Ye
Zhongshan People's Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Reproductive Biology and Endocrinology.
No community comments so far
Editorial decision: Minor revision
On 20 Feb, 2021
Review #2 received
Received 17 Feb, 2021
Reviewer #3 agreed
On 14 Feb, 2021
Review #1 received
Received 14 Feb, 2021
Review #3 received
Received 14 Feb, 2021
Reviewer #2 agreed
On 12 Feb, 2021
Reviewers invited
Invitations sent on 11 Feb, 2021
Reviewer #1 agreed
On 11 Feb, 2021
Editor assigned
On 30 Jan, 2021
Submission checks complete
On 30 Jan, 2021
Editor invited
On 30 Jan, 2021
Version 1
Posted 09 Nov, 2020
No comments provided
Editorial decision: Major revision
On 16 Dec, 2020
Review #3 received
Received 15 Dec, 2020
Reviewer #4 agreed
On 07 Dec, 2020
Review #2 received
Received 05 Dec, 2020
Reviewer #3 agreed
On 04 Dec, 2020
Reviewer #2 agreed
On 04 Dec, 2020
Review #1 received
Received 15 Nov, 2020
Reviewer #1 agreed
On 11 Nov, 2020
Reviewers invited
Invitations sent on 10 Nov, 2020
First submitted
On 31 Oct, 2020
Editor assigned
On 31 Oct, 2020
Submission checks complete
On 31 Oct, 2020
Editor invited
On 31 Oct, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Endocrinology & Metabolism
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Reproductive Biology and Endocrinology.
Background: Some studies stated that intra-uterine insemination (IUI) with controlled ovarian stimulation (COS) might increase the chance of pregnancy, while others suggested that IUI in natural cycle (NC) should be the treatment of first choice. Whether it is necessary to use COS at the same time, when IUI is applied to treat male infertility solely? There is still no consensus.
Objective: To investigate the efficacy of IUI with COS in male infertility solely?
Methods: 544 IUI cycles from 280 couples who sought medical care for male infertility from January 2010 to February 2019 were divided into two groups: group NC-IUI and group COS-IUI. Besides, the COS-IUI group was further divided into two subgroups according to the number of pre-ovulatory follicles on the day of HCG: cycles with monofollicular development (1 follicle group) and cycles with at least two pre-ovulatory follicles (≥ 2 follicles group). The outcome of IUI, including clinical pregnancy rate, live birth rate, spontaneous abortion rate, ectopic pregnancy rate and multiple pregnancy rate were compared.
Results: The clinical pregnancy rate, live birth rate, early spontaneous abortion rate, and ectopic pregnancy rate were comparable between NC-IUI group and COS-IUI group. Similar results were observed among NC-IUI group, 1 follicle group and ≥ 2 follicles group. However, when it comes to the multiple pregnancy rate, a trend toward higher multiple pregnancy rate was observed in the COS-IUI group compared that in the NC-IUI group (10.5% (2/19) vs. 0 (0/42), P=0.093), furthermore, a significant difference was found between NC-IUI group and ≥ 2 follicles group (0 vs. 20%, P =0.034).
Conclusion: For male infertility, since in cycles with COS, especially in those with at least two pre-ovulatory follicles cycles, the multiple pregnancy rate increased without substantial gain in overall pregnancy rate, COS in IUI should not be recommended. If COS is required, one stimulated follicle and one health baby should be the goal considering the safety both for mothers and fetuses.
Figure 1
Figure 1
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