Relationship between Number of Mature Follicles and Pregnancy Rates in IUI Cycles in Women 38 to 43 Years Old

Background: Although the number of follicles at intrauterine insemination (IUI) is associated with the pregnancy rates and multiple pregnancy rates. Multiple pregnancy rates are low in older women. Therefore, this study was undertaken to determine the clinical pregnancy rate of IUI in women 38–43 ye...

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Main Authors: Naama Steiner, Maryam Al Shatti, Russell Frank, Keren Rotshenker-Olshinka, Jacob Ruiter-Ligeti, Michael H. Dahan
Format: Article
Language:English
Published: IMR Press 2023-01-01
Series:Clinical and Experimental Obstetrics & Gynecology
Subjects:
Online Access:https://www.imrpress.com/journal/CEOG/50/2/10.31083/j.ceog5002023
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author Naama Steiner
Maryam Al Shatti
Russell Frank
Keren Rotshenker-Olshinka
Jacob Ruiter-Ligeti
Michael H. Dahan
author_facet Naama Steiner
Maryam Al Shatti
Russell Frank
Keren Rotshenker-Olshinka
Jacob Ruiter-Ligeti
Michael H. Dahan
author_sort Naama Steiner
collection DOAJ
description Background: Although the number of follicles at intrauterine insemination (IUI) is associated with the pregnancy rates and multiple pregnancy rates. Multiple pregnancy rates are low in older women. Therefore, this study was undertaken to determine the clinical pregnancy rate of IUI in women 38–43 years of age based on the number of stimulated mature follicles. Methods: A retrospective cohort study was performed including all the first to third stimulated IUI cycles conducted after the age of 38 years in a single academic fertility center between January 2011 and March 2018. Results: A total of 1574 IUI cycles were included in the study. The patients were divided according to the number of mature follicles (>14 mm in diameter) at the last ultrasound before the human chorionic gonadotropin (hCG) trigger. The total pregnancy rate was 9.1% and only 5 multiple pregnancies occurred. The parity (p = 0.049), the number of follicles 10–14 mm (p = 0.002), and the peak endometrial thickness (p = 0.003) were significantly different between the groups. No statistical difference was observed between the groups regarding pregnancy rates (p = 0.93) and clinical pregnancy rates (p = 0.21). Multivariate logistic regression controlling for confounding effects comparing clinical pregnancy rates with the standard as 1 follicle 14 mm or greater as benchmark did not alter the results. Conclusions: In women 38 to 43 years of age undergoing controlled ovarian hyperstimulation (COH)/IUI, one mature follicle yielded similar pregnancy and clinical pregnancy rates compared to multiple follicles, possibly due to the aneuploidy rate at this age.
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spelling doaj.art-4ba61063ed7b4fb4915ce76948f644642023-02-28T08:29:05ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-01-015022310.31083/j.ceog5002023S0390-6663(22)01959-5Relationship between Number of Mature Follicles and Pregnancy Rates in IUI Cycles in Women 38 to 43 Years OldNaama Steiner0Maryam Al Shatti1Russell Frank2Keren Rotshenker-Olshinka3Jacob Ruiter-Ligeti4Michael H. Dahan5Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, QC H2L 4S8, CanadaDepartment of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, QC H2L 4S8, CanadaDepartment of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, QC H2L 4S8, CanadaDepartment of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, QC H2L 4S8, CanadaDepartment of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, QC H2L 4S8, CanadaDepartment of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, QC H2L 4S8, CanadaBackground: Although the number of follicles at intrauterine insemination (IUI) is associated with the pregnancy rates and multiple pregnancy rates. Multiple pregnancy rates are low in older women. Therefore, this study was undertaken to determine the clinical pregnancy rate of IUI in women 38–43 years of age based on the number of stimulated mature follicles. Methods: A retrospective cohort study was performed including all the first to third stimulated IUI cycles conducted after the age of 38 years in a single academic fertility center between January 2011 and March 2018. Results: A total of 1574 IUI cycles were included in the study. The patients were divided according to the number of mature follicles (>14 mm in diameter) at the last ultrasound before the human chorionic gonadotropin (hCG) trigger. The total pregnancy rate was 9.1% and only 5 multiple pregnancies occurred. The parity (p = 0.049), the number of follicles 10–14 mm (p = 0.002), and the peak endometrial thickness (p = 0.003) were significantly different between the groups. No statistical difference was observed between the groups regarding pregnancy rates (p = 0.93) and clinical pregnancy rates (p = 0.21). Multivariate logistic regression controlling for confounding effects comparing clinical pregnancy rates with the standard as 1 follicle 14 mm or greater as benchmark did not alter the results. Conclusions: In women 38 to 43 years of age undergoing controlled ovarian hyperstimulation (COH)/IUI, one mature follicle yielded similar pregnancy and clinical pregnancy rates compared to multiple follicles, possibly due to the aneuploidy rate at this age.https://www.imrpress.com/journal/CEOG/50/2/10.31083/j.ceog5002023controlled ovarian hyperstimulation (coh)intrauterine insemination (iui)older patientsinfertility
spellingShingle Naama Steiner
Maryam Al Shatti
Russell Frank
Keren Rotshenker-Olshinka
Jacob Ruiter-Ligeti
Michael H. Dahan
Relationship between Number of Mature Follicles and Pregnancy Rates in IUI Cycles in Women 38 to 43 Years Old
Clinical and Experimental Obstetrics & Gynecology
controlled ovarian hyperstimulation (coh)
intrauterine insemination (iui)
older patients
infertility
title Relationship between Number of Mature Follicles and Pregnancy Rates in IUI Cycles in Women 38 to 43 Years Old
title_full Relationship between Number of Mature Follicles and Pregnancy Rates in IUI Cycles in Women 38 to 43 Years Old
title_fullStr Relationship between Number of Mature Follicles and Pregnancy Rates in IUI Cycles in Women 38 to 43 Years Old
title_full_unstemmed Relationship between Number of Mature Follicles and Pregnancy Rates in IUI Cycles in Women 38 to 43 Years Old
title_short Relationship between Number of Mature Follicles and Pregnancy Rates in IUI Cycles in Women 38 to 43 Years Old
title_sort relationship between number of mature follicles and pregnancy rates in iui cycles in women 38 to 43 years old
topic controlled ovarian hyperstimulation (coh)
intrauterine insemination (iui)
older patients
infertility
url https://www.imrpress.com/journal/CEOG/50/2/10.31083/j.ceog5002023
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