Scoring prognostic factors for pregnancy post-intrauterine insemination in couples with infertility.

INTRODUCTION

intrauterine insemination (IUI) was selected as a treatment for infertility due to its simple method, affordability, and non-invasive. Intrauterine insemination had pregnancy rates after one cycle of IUI ranging between 8.2% and 15.1%. Candidates for IUI are couples facing specific infertility including cervical factors, ovulatory dysfunction, endometriosis, and ejaculation. Therefore, this study aimed to assess prognostic factors significantly affecting the outcome of IUI in Indonesia before the IUI procedure.

METHODS

this study was conducted at Bocah Indonesia Fertility Clinic, Tangerang, and SMART IVF Anna Hospital, Bekasi, using an observational analytic method with a cohort retrospective design. Data were collected from infertile couples subjected to IUI between 2020 and 2024. The primary outcome measured was biochemical pregnancy, defined as a positive serum human chorionic gonadotropin (hCG) test following IUI. Prognostic factors for pregnancy were assessed and identified, while a predictive scoring system was developed using a multivariate analysis.

RESULTS

a total of 443 IUI cycles were evaluated and a pregnancy rate of 13.5% was observed. Multivariate analysis showed that pregnancy rates were influenced by the body mass index (BMI) of the male (<27.5 kg/m), age of the female (<30.5 years old), total progressive sperm count after sperm preparation (>15.81 million), first insemination, anti-mullerian hormone (AMH) level (>3.015 ng/mL), and endometrial thickness (>9.36 mm). A scoring system ranging from 0-9 was developed, with a probability of pregnancy from 1.31% to 55.16%, for scores 0 to 9, respectively.

CONCLUSION

the scoring system served as a tool designed specifically to evaluate the relationship between prognostic factors and post-IUI pregnancy rates.