The Use of Tenaculum During Intrauterine Insemination May Not Affect the Pregnancy Outcome

다국어 초록 (Multilingual Abstract)

Purpose: The association between tenaculum application to the cervix just before embryo transfer and lower pregnancy rate has been reported. However, studies on the use of tenaculum in intrauterine insemination (IUI) cycles are not available. This study attempted to investigate whether the use of tenaculum affects the clinical outcomes of IUI. Materials and Methods: Two hundred and thirty three CC/hMG/IUI cycles of one hundred and forty three couples were recruited at Seoul National University Hospital from October 2006 to December 2008. Mock insemination and IUI with or without tenaculum application to the cervix were also performed, and clinical pregnancy rate was compared. Results: The incidence of difficult mock insemination at the beginning of cycle was higher in the tenaculum use group (p <0.001). No significant statistical difference in the clinical pregnancy rate was observed between the groups with or without tenaculum application (12.1% vs. 18.5%; p =0.175), which was not influenced by the difficulty of mock insemination. Conclusion:The use of tenaculum during IUI may not affect the pregnancy outcome. Our results need to be confirmed by a prospective study in a larger population.

참고문헌 (Reference)

1 Lesny P, "Uterine junctional zone contractions during assisted reproduction cycles" 4 : 440-445, 1998

2 Fanchin R, "Uterine contractions at the time of embryo transfer alter pregnancy rates after in-vitro fertilization" 13 : 1968-1974, 1998

3 Strawn E, "Use of Sydney IVF Embryo Transfer Set Dramatically Reduces the Need for Tenaculum Use for Embryo Transfer (ET)" 84 : S159-, 2005

4 Hughes EG, "The effectiveness of ovulation induction and intrauterine insemination in the treatment of persistent infertility: a meta-analysis" 12 : 1865-1872, 1997

5 Merviel P, "Predictive factors for pregnancy after intrauterine insemination (IUI): an analysis of 1038 cycles and a review of the literature" 93 : 79-88, 2010

6 Lesny P, "Junctional zone contractions and embryo transfer: is it safe to use a tenaculum?" 14 : 2367-2370, 1999

7 Campana A, "Intrauterine insemination: evaluation of the results according to the woman’s age, sperm quality, total sperm count per insemination and life table analysis" 11 : 732-736, 1996

8 Nuojua-Huttunen S, "Intrauterine insemination treatment in subfertility: an analysis of factors affecting outcome" 14 : 698-703, 1999

9 Ombelet W, "Intrauterine insemination after ovarian stimulation with clomiphene citrate: predictive potential of inseminating motile count and sperm morphology" 12 : 1458-1463, 1997

10 Silverberg KM, "Follicular size at the time of human chorionic gonadotropin administration predicts ovulation outcome in human menopausal gonadotropin-stimulated cycles" 56 : 296-300, 1991

11 Lesny P, "Embryo transfer--can we learn anything new from the observation of junctional zone contractions?" 13 : 1540-1546, 1998

12 Van Voorhis BJ, "Effect of the total motile sperm count on the efficacy and cost-effectiveness of intrauterine insemination and in vitro fertilization" 75 : 661-668, 2001

13 Badawy A, "Clomiphene citrate or aromatase inhibitors for superovulation in women with unexplained infertility undergoing intrauterine insemination: a prospective randomized trial" 92 : 1355-1359, 2009

14 Nyboe Andersen A, "Assisted reproductive technology and intrauterine inseminations in Europe, 2005: results generated from European registers by ESHRE: ESHRE. The European IVF Monitoring Programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE)" 24 : 1267-1287, 2009

15 Manganiello PD, "A comparison of clomiphene citrate and human menopausal gonadotropin for use in conjunction with intrauterine insemination" 68 : 405-412, 1997