Relationship between Preovulatory Dominant Follicle Size and the Outcome of Artificial Insemination with Donor Sperm

doi:10.12280/gjszjk.20200513

Abstract

Abstract:

Objective: To investigate the relastionship between preovulatory dominant follicle size (PDFS) and the outcome of artificial insemination with donor sperm (AID) in natural cycle (NC) and the ovulation induction cycles using clomiphene citrate (CC) or letrozole (LE) respectively.Methods: The clinical data of 2 675 natural cycles (NC-AID), 547 CC-induced cycles (CC-AID) and 1 566 LE-induced cycles (LE-AID) in AID procedures performed between January 2012 and August 2019 were retrospectively analyzed. These AID cycles were respectively grouped according to preovulatory dominant follicle size(PDFS) to understand the variation characteristics of AID outcomes, and to group them respectively into two sub-groups: the dominant group and the control group. The relative advantages of the dominant group in terms of intrauterine pregnancy rate (IPR) and ongoing pregnancy rate (OPR) were analyzed by the univariate and multivariate logical regression.Results: In NC-AID, the IPR and OPR in PDFS 16.0-19.9 mm were significantly higher than those in PDFS ≥20.0 mm (23.01% vs. 19.13%, aOR=1.260, P=0.035; 20.57% vs. 16.88%, aOR=1.277, P=0.034). In CC-AID, the IPR in PDFS 18.0-21.9 mm was significantly higher than that in PDFS<18.0 mm or ≥22.0 mm (26.86% vs. 16.85%, aOR=1.898, P=0.036). In LE-AID, the IPR and OPR in PDFS 18.0-20.0 mm were significantly higher than those in PDFS<18.0 mm or≥20.0 mm (23.90% vs. 18.08%, aOR=1.405, P=0.013; 22.28% vs. 16.35%, aOR=1.449, P=0.009).Conclusions: In AID procedure, the optimal ranges of PDFS in the NC, CC or LE cycles were 16.0-19.9 mm, 18.0-21.9 mm and 18.0-20.0 mm, respectively.

Key words: Ovulation induction, Insemination, artificial, Pregnancy rate, Clomiphene, Aromatase inhibitors, Preovulatory dominant follicle size

NI Li-li, WANG Jing, DIAO Fei-yang, MA Xiang, MAO Yun-dong, LIU Jia-yin, LIU Jin-yong. Relationship between Preovulatory Dominant Follicle Size and the Outcome of Artificial Insemination with Donor Sperm[J]. Journal of International Reproductive Health/Family Planning, 2021, 40(1): 1-5.

Figures/Tables 8

References 18

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按助孕结局分组	周期数	女方年龄（周岁）	女方BMI（kg/m²）	周期序号	卵泡期天数（d）	内膜厚度（mm）	精子浓度（×10⁶/mL）	PR总数（×10⁶）
宫内妊娠组	588	27.67±3.21	21.68±2.73	1.53±0.85	15.22±3.14	10.52±1.93	50.09±14.81	16.72±6.09
未获宫内妊娠组	2 087	28.20±3.37	21.63±2.90	1.64±0.98	15.34±3.25	10.25±1.97	49.54±13.77	16.69±6.00
t		3.406	0.352	2.731	0.742	2.883	0.848	0.097
P		0.001	0.725	0.006	0.458	0.004	0.397	0.923
持续妊娠组	524	27.59±3.16	21.57±2.65	1.54±0.87	15.19±3.14	10.54±1.95	50.28±15.01	16.76±6.19
未获持续妊娠组	2 151	28.21±3.38	21.66±2.91	1.63±0.97	15.34±3.25	10.25±1.97	49.51±13.75	16.68±5.97
t		3.987	0.698	2.138	0.956	2.962	1.122	0.287
P		<0.001	0.485	0.033	0.339	0.003	0.262	0.774

按助孕结局分组	周期数	女方年龄（周岁）	女方BMI（kg/m²）	周期序号	卵泡期天数（d）	内膜厚度（mm）	精子浓度（×10⁶/mL）	PR总数（×10⁶）
宫内妊娠组	588	27.67±3.21	21.68±2.73	1.53±0.85	15.22±3.14	10.52±1.93	50.09±14.81	16.72±6.09
未获宫内妊娠组	2 087	28.20±3.37	21.63±2.90	1.64±0.98	15.34±3.25	10.25±1.97	49.54±13.77	16.69±6.00
t		3.406	0.352	2.731	0.742	2.883	0.848	0.097
P		0.001	0.725	0.006	0.458	0.004	0.397	0.923
持续妊娠组	524	27.59±3.16	21.57±2.65	1.54±0.87	15.19±3.14	10.54±1.95	50.28±15.01	16.76±6.19
未获持续妊娠组	2 151	28.21±3.38	21.66±2.91	1.63±0.97	15.34±3.25	10.25±1.97	49.51±13.75	16.68±5.97
t		3.987	0.698	2.138	0.956	2.962	1.122	0.287
P		<0.001	0.485	0.033	0.339	0.003	0.262	0.774

按助孕结局分组	周期数	女方年龄（周岁）	女方BMI（kg/m²）	周期序号	卵泡期天数（d）	内膜厚度（mm）	精子浓度（×10⁶/mL）	PR总数（×10⁶）
宫内妊娠组	138	27.67±3.22	21.87±2.73	2.04±1.02	14.27±2.26	9.91±2.12	51.38±14.33	16.41±4.89
未获宫内妊娠组	409	28.38±3.14	21.91±2.74	2.17±1.13	14.12±2.15	9.42±2.23	49.78±13.73	16.62±5.76
t		2.279	0.145	1.203	0.679	2.268	1.165	0.386
P		0.023	0.885	0.230	0.497	0.024	0.245	0.700
持续妊娠组	117	27.50±3.13	21.86±2.76	2.01±1.01	14.22±2.21	9.81±2.07	50.46±14.23	16.16±4.91
未获持续妊娠组	430	28.40±3.16	21.92±2.73	2.18±1.12	14.14±2.17	9.47±2.25	50.11±13.81	16.68±5.71
t		2.740	0.207	1.556	0.353	1.461	0.241	0.903
P		0.006	0.836	0.121	0.724	0.145	0.809	0.367

按助孕结局分组	周期数	女方年龄（周岁）	女方BMI（kg/m²）	周期序号	卵泡期天数（d）	内膜厚度（mm）	精子浓度（×10⁶/mL）	PR总数（×10⁶）
宫内妊娠组	138	27.67±3.22	21.87±2.73	2.04±1.02	14.27±2.26	9.91±2.12	51.38±14.33	16.41±4.89
未获宫内妊娠组	409	28.38±3.14	21.91±2.74	2.17±1.13	14.12±2.15	9.42±2.23	49.78±13.73	16.62±5.76
t		2.279	0.145	1.203	0.679	2.268	1.165	0.386
P		0.023	0.885	0.230	0.497	0.024	0.245	0.700
持续妊娠组	117	27.50±3.13	21.86±2.76	2.01±1.01	14.22±2.21	9.81±2.07	50.46±14.23	16.16±4.91
未获持续妊娠组	430	28.40±3.16	21.92±2.73	2.18±1.12	14.14±2.17	9.47±2.25	50.11±13.81	16.68±5.71
t		2.740	0.207	1.556	0.353	1.461	0.241	0.903
P		0.006	0.836	0.121	0.724	0.145	0.809	0.367

按助孕结局分组	周期数	女方年龄（岁）	女方BMI（kg/m²）	周期序号	卵泡期天数（d）	内膜厚度（mm）	精子浓度（×10⁶/mL）	PR总数（×10⁶）
宫内妊娠组	344	27.72±3.28	21.78±2.82	2.23±0.98	13.71±2.17	9.39±1.99	48.20±11.20	15.99±4.41
未获宫内妊娠组	1222	28.30±3.55	22.10±3.10	2.54±1.14	13.58±1.95	9.39±1.88	48.07±11.64	15.48±4.57
t		2.814	1.745	4.945	1.099	0.026	0.196	1.827
P		0.005	0.081	<0.001	0.272	0.979	0.845	0.068
持续妊娠组	318	27.72±3.23	21.79±2.81	2.24±1.00	13.70±2.19	9.33±1.97	48.15±11.22	15.95±4.37
未获持续妊娠组	1248	28.30±3.55	22.09±3.10	2.53±1.13	13.58±1.96	9.40±1.89	48.08±11.62	15.50±4.57
t		2.822	1.564	4.553	0.873	0.567	0.090	1.572
P		0.005	0.118	<0.001	0.383	0.571	0.928	0.116