To Explore The Factors Affecting The Pregnancy Of Uterine Endocardiff Artificial Insemination Procedure

[OBJECTIVE]This study was aimed to explore the relevant factors of intrauterine insemination(IUI)pregnancy procedure,by review 2015 whole year's historical data(from Jan 1st to Dec.31st 2015)collected from the Reproductive Medical Center of the First Affiliated Hospital of Soochow University,during this period total 273 pairs of patients had been.treated and a total of 510 cycles' data were collected.From collected data and clinical pregnancy rates,and by analyzing and comparing different relevant factors that will affect IUI procedure successfulness,hope to get some insights about some key factors,with which could further instruct clinical pre-screening and minimize downside factors beforehand,in term to increase clinical pregnancy rate of IUI.[MATERIALAAND METHODS]This study was based on in-depth retrospective analysis and comparison on clinical data collected for year 2015.The data collected include patient's age,body mass index(BMI),the reason of infertility,the baseline levels of relevant hormones(including follicle-stimulating hormone(FSH),the levels of estrogen(E2),the levels of luteinizing hormone(LH),the levels of T),duration to procedure day(days up to HCG injection),the endometrial thickness in hCG injection,the follicle diameter in hCG injection,the levels of E,LH,P in hCG injection,and cycles,etc.Analyze and comparison of patient pregnancy rates based on these data collected.Statistical analysis was performed using SPSS 19.0 software.For group non-continuous data comparison(e.g.pregnancy group and non-pregnancy group,different ovulation stimulating drug usage schema),Chi-square test and t-test were used.In addition,the method of nonparametric test,"One-Sample Kolmogorov Smirnov Test" was used for continuous data.If the data were accorded with normal distribution,the independent sample t-test was used to compare the differences between the two groups;if not,the Mann-Whitney U test was used to compare the differences between the two groups.[RESULTS]1.In 510 cycles' IUI procedures data collected,pregnancy number was 56;overall clinical pregnancy rate was 10.98%,with biochemical pregnancy rate of 0.98%.For subgroup of natural and ovulation stimulating drug usage subgroups,natural cycles had pregnancy rate of 6.37%while ovulation stimulating drug usage cycles had pregnancy rate of 21.15%,which obvious and statistical significant increased pregnancy rate observed(p<0.05).Both subgroups had biochemical pregnancy rate of 0.98%;2.Cycles and ovulation stimulating drug usage:1)CC(clomiphene).LE(letrozole).CC+HMG(hysterosalpingography).LE+HMG?HMG ovulation stimulating drug usage schema's pregnancy numbers were 12.38%?10.96%?17.5%?18.33%?17.39%respectively;2)FSH(follicle-stimulating hormone)+HMG?LE+FSH?LE+HMG+FSH ovulation stimulating drug usage schema had limited cycles and did not have successful pregnancy;3.Multiple pregnancies(MP)rate and adverse pregnancy outcomes1)Natural cycles' MP rate is 7.69%,while ovulation stimulating drug cycles had 13.95%,ovulation stimulating drug cycles had higher MP rate than natural cycles,but no statistical significance(p>0.05).In CC,LE+HMG,HMG subgroups,MP rate is 15.387%,27.27%and 25%respectively;other stimulating schema had no MP.2)Biochemical pregnancy rates of ovulation stimulating drug cycles and natural cycles were both 0.98%.while within ovulation stimulating drug cycles,CC and LE had biochemical pregnancy rates of 1.90%and 1.37%;other stimulating schema had no biochemical pregnancy.4.Analyze the age factor,26-29 group's pregnancy rate was 21.88%,30-35 group's was 22.43%,while 36-39 group's was 8.33%.For patients younger than 35,the pregnancy rate was obviously higher than those older than 35.5.With the data collected by this study,analyze by reasons of infertility,ovulation inhibition,male factors,unknown factors,endometriosis(EM),tubal factor infertility and both sides factors subgroups had occurrence rate of 28.99%?29.03%?26.09%?19.35%?4%?3.85%and 10.52%respectively.And ovulation inhibition,male factors,unknown factors subgroups had relatively higher pregnancy rates under IUI procedures,compared to tubal factor infertility and endometriosis(EM),with statistical significance(p<0.05);6.Analyze cycle numbers of IUI procedures participated from this study's pooled data,patients with 1 cycle had the highest pregnancy rate of 27.50%,2 cycles of 17.33%,3 cycles dropped to 10.96%,while>4 cycles,no successful pregnancy case.The pregnancy rate of 1-2 cycles was statistically significant higher than of>3 cycles(p<0.05).[CONCLUSIONS]1.In this study,ovulation stimulating drug used cycles had relatively higher pregnancy rate compared to natural cycles;2.In this study,for single drug usage in ovulation stimulating drug usage schema,LE had relatively lower MP rate thus considered safer;while in combo usage,CC+HMG schema was better;3.For patients older than 35,the pregnancy rate dropped significantly.4.Ovulation inhibition,male factors and unknown factors' group had relatively higher successful rates under IUI procedures in this study.For tubal factor infertility and endometriosis(EM)patients,more pro-active selection and pre-conditioning steps should"be taken to increase the successful rate.5.The first 1-2 cycles of IUI procedures were with much higher pregnancy successful rate.Recommend patients who failed 2-3 cycles of IUI actively seeking for other facilitation methods;6.For patients who were primary infertility,recommend use ovulation stimulating drug while trying IUI procedure.