Effect of infertility duration on the success rate of intrauterine insemination by husband sperm
Objective:To investigate the effect of infertility duration on pregnancy outcomes of intrauterine artificial insemination with husband semen(AI H).Methods:A retrospective cohort study was conducted to analyze the clinical data of patients who underwent AIH in Henan Provincial People's Hospital from September 2016 to June 2023,with a total of 3 465 cycles.Multivariate logistic regression analysis,curve fitting,and stratified analysis according to age,anti-Müllerian hormone(AMH)level,ovulation induction,and the second insemination in the cycle were used to explore the effect of infertility duration on the clinical outcomes of AIH.Results:In AIH cycles recruited,the average age of women was(30.64±4.00)years,the average duration of infertility was(3.19±1.94)years,and the clinical pregnancy rate was 13.25％(459/3 465).Multivariate logistic regression analysis showed that the duration of infertility was an independent influencing factor of clinical pregnancy rate[OR=0.94,95％CI(0.88,0.99),P=0.026 7],and the clinical pregnancy rate decreased by 6％for each additional year of the duration of infertility.The results of curve fitting showed that the clinical pregnancy rate decreased with the increase of infertility duration,and the effect was approximately a straight line without an inflection point.The results of stratified analysis showed that the effect of infertility duration on clinical pregnancy rate was not significant in women with high ovarian reserve,using ovarian stimulation cycle,and the second insemination in the cycle(P＞0.05).Conclusions:With the increase of infertility duration,the clinical pregnancy rate after AIH decreases.However,patients with a long history of infertility still have the possibility of pregnancy after AIH,especially in patients with high ovarian reserve.In addition,AIH and two cycles of artificial insemination before and after ovulation may help to improve the clinical pregnancy rate.
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