Intrauterine insemination treatment in subfertility: an analysis of factors affecting outcome

A total of 811 intrauterine insemination (IUI) cycles in which clomiphene c itrate/human menopausal gonadotrophin (HMG) was used for ovarian stimulatio n were analysed retrospectively to identify prognostic factors regarding tr eatment outcome. The overall pregnancy rate was 12.6% per cycle, the multip le pregnancy rate 13.7%, and the miscarriage rate 23.5%. Logistic regressio n analysis revealed five predictive variables as regards pregnancy: number of the treatment cycle (P = 0.009), duration of infertility (P = 0.017), ag e (P = 0.028), number of follicles (P = 0.031) and infertility aetiology (P = 0.045). The odds ratios for age <40 years, unexplained infertility aetio logy (versus endometriosis) and duration of infertility less than or equal to 6 years were 3.24, 2.79 and 2.33, respectively. A multifollicular ovaria n response to clomiphene citrate/HMG resulted in better treatment success t han a monofollicular response, and 97% of the pregnancies were obtained in the first four treatment cycles. The results indicate that clomiphene citra te/HMG/IUI is a useful and cost-effective treatment option in women <40 yea rs of age with infertility duration less than or equal to 6 years, who do n ot suffer from endometriosis.