The relationship between duration of infertility and intrauterine insemination: a multi-centers study

Abstract Introduction: The duration of infertility should be considered as a factor that may affect the outcome of Assisted Reproductive Techniques (ART). The aim of the present work is to examine the outcome of infertility treatment in relation to duration of infertility. Materials and methods: One hundred fifty-two couples with mild male infertility factor were involved in this retrospective study. Sixty nine couples from Allow In vitro Fertilization center (IVF), and remaining (83 couples) from Embryo Research and Infertility Treatment; Al-Nahrain University, Baghdad-Iraq. Intrauterine Insemination (IUI) had been done for all couples using the same ART. Results: The mean age of men was 35.88 ± 0.57 years and the duration of infertility was 5.44 ± 0.29 year (range=1-19 years). The higher pregnancy and life-birth rates was demonstrated in those couples suffering from infertility for duration less than 4 years in compare to those who had duration more than 10 years (P<0.003, r=-0.869). Abortion rate was observed in those couples who had duration more than 10 years in compare to those who have duration of infertility less than 4 years (P<0.0014). The linear life-birth rate, in both IVF centers, shows decrease by increase in the duration of infertility. Conclusion: The researchers conclude that by increase in the duration of infertility the outcome of assisted reproductive techniques -IUI will be decreased markedly. Keywords: Infertility; ART; IUI; Life birth rat

Late Luteal Hyperprolactinemia (LL-HPRL) is not a disease..!!!

Prolactin (PRL) is an exceptional hormone of pituitary gland with important implications for normal reproduction as well as for sexual behavior. It increases in the first trimester of pregnancy (physiological hyperprolactinemia). The objective of this study is to evaluate the usefulness of LL-HPRL as an indicator for early ongoing pregnancy in patients undergoing treatment for infertility. This is a retrospective study on one hundred and eleven women who had beenundergoing treatment for infertilityand their husbands were known to be reproductively fertile. Women with knownother causesof infertility, besides anovulation and luteal phase deficiency were excluded from the study population. They were divided into two groups matched for age and Body-Mass Index (BMI); control group A: 76 pregnant women on no anti-LF-HPRL therapy and study group B: 35 pregnant women on anti-LF-HPRL therapy. All women in both groups had been treated for hyperprolactinemia until their PRL levels were normal. Later, after one menstrual cycle, both groups had been enrolled in a Controlled Ovarian hyperstimulation (COS) Program. The COS aimed to induce 2-3 mature follicles/women/cycle. Duringthe study period (34 months), the ovulation, pregnancy, abortion and live-birth rates were evaluated. The withdrawal rate of patients was also recorded. No significant differences were observed between the two groups of women regarding baseline hormonal levels (FSH, LH, LH/FSH, testosterone, estradiol and PRL (p<0.03). However, the progesterone levels at day 21 of the cycle was significantly different between study and control groups (4.52±4.91 and 5.36±4.73, respectively, p<0.02). The serum PRL at 28th day of ovulation induction cycle was significantly different between the study and control groups (28.32±11.89 and 7.53±5.69, respectively, p<0.001). The ovulation, ongoing pregnancy, life-birth rates were significantly higher in the study group in comparison to control group (p<0.001). Early abortion and cancelation rates were significantly higher in control than in study group (p<0.001). High serum prolactin levels in the Late Follicular menstrual Phase (LF-HPRL) in infertile women treated by ovulation induction after having completed therapy for hyperprolactinemia is an early indicator for diagnosis of ongoing pregnancy, consequently treatment of LF-HPRL is not recommended