Success of IUI in Women with Unexplained Infertility: Evaluation of Predictive Factors

Objective: To evaluate the predictive factors associated with successful intrauterine insemination (IUI)

Methods: A prospective observational study included 130 women with unexplained infertility and planned to IUI after controlled ovarian stimulation. The semen was prepared by swim up technique and IUI was done 24 hours after hCG injection using 0.3 -0.5 ml of sperm suspension using sperm transcervical catheter attached to a 1 ml tuberculin syringe

Results: There was a significant difference between the 2 study groups regarding BMI (30.59±4.93 vs. 28.75±2.75, P value 0.05) and paternal age (27.2±5.24 vs. 31.3±5.9, P value 0.05).

There was a highly significant difference between the 2 study groups regarding maternal age (24.84±3.64 vs. 27.7±4.36, P value <0.001).

There was a highly significant difference between pregnant and non pregnant women regarding sperm count before (78.06±24.21 vs. 54.87±34.04) and after processing (63.87±23.047 vs. 40.93± 19.377), sperms with progressive motility after processing and total motile sperms after processing (30.00± 7.303 vs. 23.74± 8.93) (P value <0.001).
Pregnant women showed a significantly higher number of follicles (3.03 ± 1.18 vs. 2.18 ± 0.95 ), larger follicles (21.84±2.38 vs. 19.9±1.89)and thicker endometrium (11.29±1.49 vs. 8.42±1.73)than non pregnant ones (P value <0.001).

Conclusion: Maternal age, Body mass index, paternal age, the sperm count before and after processing, sperms with progressive motility evaluated after processing and the number of total motile sperms evaluated after processing, the number of follicles, size of largest follicle and endometrial thickness are highly predictive of success of IUI

Key Message Points
IUI is one of the lines of treatment of couples with unexplained infertility.•
Many maternal, paternal factors affect IUI success.•
Maternal age, BMI, the number of follicles , size of largest follicle and endometrial thickness are highly • predictive of success of IUI
Paternal age, the sperm count , progressive motility and the number of total motile sperms are highly • predictive of success of IUI.

Keywords: Intrauterine insemination; unexplained infertility; sperm count; maternal age; follicular count; endometrial thickness.