Impact of Estradiol Monitoring on the Prediction of Intrauterine Insemination Outcome
Remzi Atilgan, Mustafa Ekinci, Ekrem Sapmaz, Zehra Sema Ozkan
Citation Information :
Atilgan R, Ekinci M, Sapmaz E, Ozkan ZS. Impact of Estradiol Monitoring on the Prediction of Intrauterine Insemination Outcome. Int J Infertil Fetal Med 2013; 4 (3):88-92.
To evaluate the predictive value of estradiol levels on the day of human chorionic gonadotropin (hCG) administration on intrauterine insemination success rate.
Materials and methods
The present study included 200 intrauterine insemination (IUI) cycles performed between June 2011 and October 2012. All IUI cycles were preceded by ovarian stimulation with gonadotropins starting on cycle day 3. A single IUI was performed 24 to 36 hours after hCG administration. Binary logistic regression analysis was performed to define the covariates of IUI success. The main outcome measure, the clinical pregnancy rate per cycle, was assessed according to the estradiol level.
Results
With LR ± 2 and AUC=0.73, ROC analysis revealed out the estradiol level as 465 pg/ml to predict the pregnancy with 60% sensitivity and 66% specificity. Binary logistic regression analysis identified the presence of estradiol levels higher than 465 pg/ml (p < 0.01, 95% CI = 0.147 – 0.687) and stimulation duration (p < 0.01, 95% CI = 0.201 – 0.705) as the covariates approached statistical significance for IUI success.
Conclusion
Estradiol level >465 pg/ml on the day of hCG administration might point out advanced outcome on mild ovarian stimulation combined with insemination.
How to cite this article
Atilgan R, Ekinci M, Sapmaz E, Ozkan ZS. Impact of Estradiol Monitoring on the Prediction of Intrauterine Insemination Outcome. Int J Infertility Fetal Med 2013;4(3):88-92.
Place of ICSI in management of male infertility. Lanset 2001;357:2068-2069.
Intrauterine insemination: a critical review. Fertil Steril 1985;44:569-580.
Intrauterine insemination: a first-step procedure in the algorithm of male subfertility treatment. Hum Reprod 1995;10:90-102.
Intrauterine insemination or in-vitro fertilisation in idiopathic subfertility and male subfertility: a randomised trial and cost-effectiveness analysis. Lancet 2000;355:13-18.
Intrauterine insemination treatment in subfertility: an analysis of factors affecting outcome. Hum Reprod 1999;14: 698-703.
The influence of the number of follicles on pregnancy rates in intrauterine insemination with ovarian stimulation: a meta-analysis. Hum Reprod Update 2008;14: 563-570.
Laboratory manual for the examination of human semen and semen-cervical mucus interaction. 3rd ed. Cambridge: Cambridge University Press 1993;3-27.
Predictive value of abnormal sperm morphology in in vitro fertilization. Fertil Steril 1998;49:112-117.
Intrauterine insemination: a systematic review on determinants of success. Hum Reprod Update 2002;8:373-384.
Recombinant FSH versus clomiphene citrate for ovarian stimulation in couples with unexplained infertility and male subfertility undergoing intrauterine insemination: a randomized trial. Arch Gynecol Obstet 2011;284:1561-1566.
A randomized and longitudinal study of human menopausal gonadotropin with intrauterine insemination in the treatment of infertility. Obstet Gynecol 1993;82:780-786.
Efficacy of superovulation and intrauterine insemination in the treatment of infertility. National Cooperative Reproductive Medicine Network. N Engl J Med 1999;340:177-183.
Efficacy of double intrauterine insemination in controlled ovarian hyperstimulation cycles. Fertil Steril 1999;72:619-622.
Prognostic indicators for intrauterine insemination (IUI): statistical model for IUI success. Hum Reprod 1996;11: 1892-1896.
The effect of patient and semen characteristics on live birth rates following intrauterine insemination: a retrospective study. J Assist Reprod Genet 2000;17:245-252.
Approaching the next millennium: how should we manage andrology diagnosis in the intracytoplasmic sperm injection era? Fertil Steril 1997;67: 434-436.
Homologous intrauterine insemination. An evaluation of prognostic factors based on a review of 2473 cycles. Acta Obstet Gynecol Scand 2001;80:74-81.
Intrauterine insemination: evaluation of the results according to the woman's age, sperm quality, total sperm count per insemination and life table analysis. Hum Reprod 1996;11: 732-736.
Determinants of the outcome of intrauterine insemination: analysis of outcomes of 9963 consecutive cycles. Am J Obstet Gynecol 1999;180:1522-1534.
Evaluation of pregnancy rates after intrauterine insemination according to indication, age, and sperm parameters. J Assist Reprod Genet 1998;15:359-364.
Pentoxifylline increases sperm penetration into zona-free hamster oocytes without increasing the acrosome reaction. Andrologia 1993;25:359-362.
Increase of intracellular calcium is not a cause of pentoxifylline-induced hyperactivated motility or acrosome reaction in human sperm. Fertil Steril 1998;69:748-754.
