Original Articles

The Effect of the Time Interval From Sperm Processing to Intrauterine Insemination on the Pregnancy Outcomes of Infertile Women

Abstract

Objective: Intrauterine insemination (IUI) is the first-line treatment in couples suffering from various causes of subfertility and infertility. Considering the relatively low rate of pregnancy achieved with each cycle in this method, optimizing various steps in the process including the time interval from sperm collection to IUI may result in an increased rate of success. The goal of this study was to assess the impact of time intervals from the end of sperm processing to IUI (SP-IUI) on the pregnancy rate in IUI.
Materials and methods: This single-center prospective cohort study evaluated couples with normal male partner sperm analysis and idiopathic female infertility undergoing IUI from 2018 to 2021. Cycles were stimulated using subcutaneous recombinant FSH and oral Letrozole. Ovulation was triggered using GnRH antagonist when the leading follicle’s size reached greater than 14mm. The participants were placed in one of the three groups based on SP-IUI: group 1 (0–60 min), group II (60–90 min), and Group III: (>90 min).
Results: 269 couples were included in the study. Sperm processing expectedly resulted in an increased concentration of total sperm count and sperm motility (P<0.001). The rate of chemical or clinical pregnancy, abortion, IUFD, multigestation, pregnancy, term birth, and ectopic pregnancy was not significantly different across study groups (P>0.05).
Conclusion: The results of this study suggest that SP-IUI intervals evaluated in this study do not vary in terms of pregnancy rate or adverse pregnancy outcomes in IUI with normal male partner semen analysis. Hence, infertile couples can be flexible in the collection of semen specimens without time and site (at home or hospital) limitations.

1. ESHRE Capri Workshop Group. Intrauterine insemination. Hum Reprod Update 2009; 15: 265-77.
2. Song GJ, Herko R, Lewis V. Location of semen collection and time interval from collection to use for intrauterine insemination. Fertil Steril 2007; 88: 1689-91.
3. Abdelkader AM, Yeh J. The Potential Use of Intrauterine Insemination as a Basic Option for Infertility: A Review for Technology-Limited Medical Settings. Obstet Gynecol Int 2009; 2009: 584837.
4. Cantineau AE, Heineman MJ, Cohlen BJ. Single versus double intrauterine insemination in stimulated cycles for subfertile couples: a systematic review based on a Cochrane review. Hum Reprod 2003; 18: 941-6.
5. De Geyter C, Calhaz-Jorge C, Kupka MS, Wyns C, Mocanu E, Motrenko T, et al. ART in Europe, 2014: results generated from European registries by ESHRE: The European IVF-monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE). Hum Reprod 2018; 33: 1586-601.
6. Esmailzadeh S, Faramarzi M. Endometrial thickness and pregnancy outcome after intrauterine insemination. Fertil Steril 2007; 88: 432-7.
7. Miller DC, Hollenbeck BK, Smith GD, Randolph JF, Christman GM, Smith YR, et al. Processed total motile sperm count correlates with pregnancy outcome after intrauterine insemination. Urology 2002; 60: 497-501.
8. Yavuz A, Demirci O, Sözen H, Uludoğan M. Predictive factors influencing pregnancy rates after intrauterine insemination. Iran J Reprod Med 2013; 11: 227-34.
9. Cantineau AE, Cohlen BJ, Heineman MJ. Ovarian stimulation protocols (anti-oestrogens, gonadotrophins with and without GnRH agonists/antagonists) for intrauterine insemination (IUI) in women with subfertility. Cochrane Database Syst Rev 2007;(2): CD005356.
10. Agarwal A, Saleh RA, Bedaiwy MA. Role of reactive oxygen species in the pathophysiology of human reproduction. Fertil Steril 2003; 79: 829-43.
11. Wang X, Sharma RK, Sikka SC, Thomas AJ Jr , Falcone T, Agarwal A. Oxidative stress is associated with increased apoptosis leading to spermatozoa DNA damage in patients with male factor infertility. Fertil Steril 2003; 80: 531-5.
12. Yavas Y, Selub MR. Intrauterine insemination (IUI) pregnancy outcome is enhanced by shorter intervals from semen collection to sperm wash, from sperm wash to IUI time, and from semen collection to IUI time. Fertil Steril 2004; 82: 1638-47.
13. Cantineau AE, Janssen MJ, Cohlen BJ, Allersma T. Synchronised approach for intrauterine insemination in subfertile couples. Cochrane Database Syst Rev 2014 ;(12):CD006942.
14. Hammadeh ME, Strehler E, Zeginiadou T, Rosenbaum P, Schmidt W. Chromatin decondensation of human sperm in vitro and its relation to fertilization rate after ICSI. Arch Androl 2001; 47: 83-7.
15. Fauque P, Lehert P, Lamotte M, Bettahar-Lebugle K, Bailly A, Diligent C, et al. Clinical success of intrauterine insemination cycles is affected by the sperm preparation time. Fertil Steril 2014; 101: 1618-23.e3.
16. Kuru Pekcan M, Kokanalı D, Kokanalı K, Taşçı Y. Effect of time intervals from the end of sperm collection to intrauterine insemination on the pregnancy rates in controlled ovarian hyperstimulation-intrauterine insemination cycles. J Gynecol Obstet Hum Reprod 2018; 47: 561-4.
17. Cooper TG, Noonan E, Von Eckardstein S, Auger J, Baker HW, Behre HM, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010; 16: 231-45.
18. Stein A, Altman E, Rotlevi M, Deutsch A, Ben-Haroush A, Wertheimer A, et al. Does the time interval from the end of sperm processing to intrauterine insemination (lab-to-uterus time) affect treatment outcome? Andrology 2021; 9: 1859-63.
19. Jansen CHJR, Elisen MGLM, Leenstra CW, Kaaijk EM, van Stralen KJ, Verhoeve HR. Longer time interval between semen processing and intrauterine insemination does not affect pregnancy outcome. Fertil Steril 2017; 108: 764-9.
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IssueVol 16, No 3 (September 2022) QRcode
SectionOriginal Articles
DOI https://doi.org/10.18502/jfrh.v16i3.10581
Keywords
Intrauterine Insemination Sperm Collection Timing Idiopathic Infertility Subfertility

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How to Cite
1.
Rezaei Z, Feizabad E, Valadan M, Ebadizare S. The Effect of the Time Interval From Sperm Processing to Intrauterine Insemination on the Pregnancy Outcomes of Infertile Women. J Family Reprod Health. 2022;16(3):199-204.