Predictors of pregnancy and live-birth in couples with unexplained infertility after ovarian stimulation–intrauterine insemination

Karl R. Hansen, Amy Linnea W He, Aaron K. Styer, Robert A. Wild, Samantha Butts, Lawrence Engmann, Michael P. Diamond, Richard S. Legro, Christos Coutifaris, Ruben Alvero, Randal D. Robinson, Peter Casson, Gregory M. Christman, Hao Huang, Nanette Santoro, Esther Eisenberg, Heping Zhang, Michael Peter Diamond

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective To identify baseline characteristics of couples that are likely to predict conception, clinical pregnancy, and live birth after up to four cycles of ovarian stimulation with IUI in couples with unexplained infertility. Design Secondary analyses of data from a prospective, randomized, multicenter clinical trial investigating pregnancy, live birth, and multiple pregnancy rates after ovarian stimulation-IUI with clomiphene citrate, letrozole, or gonadotropins. Setting Outpatient clinical units. Patient(s) Nine-hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation clinical trial. Intervention(s) As part of the clinical trial, treatment was randomized equally to one of three arms and continued for up to four cycles or until pregnancy was achieved. Main Outcome Measure(s) Conception, clinical pregnancy, and live-birth rates. Result(s) In a multivariable logistic regression analysis, after adjustment for other covariates, age, waist circumference, income level, duration of infertility, and a history of prior pregnancy loss were significantly associated with at least one pregnancy outcome. Other baseline demographic and lifestyle characteristics including smoking, alcohol use, and serum levels of antimüllerian hormone were not significantly associated with pregnancy outcomes. Conclusion(s) While age and duration of infertility were significant predictors of all pregnancy outcomes, many other baseline characteristics were not. The identification of level of income as a significant predictor of outcomes independent of race and education may reflect differences in the underlying etiologies of unexplained infertility or could reveal disparities in access to fertility and/or obstetrical care. Clinical Trial Registration NCT01044862.

Original languageEnglish (US)
Pages (from-to)1575-1583.e2
JournalFertility and sterility
Volume105
Issue number6
DOIs
StatePublished - Jun 1 2016

Fingerprint

Insemination
Live Birth
Infertility
Ovulation Induction
Pregnancy
Pregnancy Outcome
letrozole
Clinical Trials
Pregnancy Rate
Multiple Pregnancy
Reproductive History
Clomiphene
Waist Circumference
Gonadotropins
Multicenter Studies
Fertility
Life Style
Outpatients
Randomized Controlled Trials
Logistic Models

Keywords

  • Unexplained infertility
  • intrauterine insemination
  • ovarian stimulation
  • predictors
  • pregnancy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Predictors of pregnancy and live-birth in couples with unexplained infertility after ovarian stimulation–intrauterine insemination. / Hansen, Karl R.; He, Amy Linnea W; Styer, Aaron K.; Wild, Robert A.; Butts, Samantha; Engmann, Lawrence; Diamond, Michael P.; Legro, Richard S.; Coutifaris, Christos; Alvero, Ruben; Robinson, Randal D.; Casson, Peter; Christman, Gregory M.; Huang, Hao; Santoro, Nanette; Eisenberg, Esther; Zhang, Heping; Diamond, Michael Peter.

In: Fertility and sterility, Vol. 105, No. 6, 01.06.2016, p. 1575-1583.e2.

Research output: Contribution to journalArticle

Hansen, KR, He, ALW, Styer, AK, Wild, RA, Butts, S, Engmann, L, Diamond, MP, Legro, RS, Coutifaris, C, Alvero, R, Robinson, RD, Casson, P, Christman, GM, Huang, H, Santoro, N, Eisenberg, E, Zhang, H & Diamond, MP 2016, 'Predictors of pregnancy and live-birth in couples with unexplained infertility after ovarian stimulation–intrauterine insemination', Fertility and sterility, vol. 105, no. 6, pp. 1575-1583.e2. https://doi.org/10.1016/j.fertnstert.2016.02.020
Hansen, Karl R. ; He, Amy Linnea W ; Styer, Aaron K. ; Wild, Robert A. ; Butts, Samantha ; Engmann, Lawrence ; Diamond, Michael P. ; Legro, Richard S. ; Coutifaris, Christos ; Alvero, Ruben ; Robinson, Randal D. ; Casson, Peter ; Christman, Gregory M. ; Huang, Hao ; Santoro, Nanette ; Eisenberg, Esther ; Zhang, Heping ; Diamond, Michael Peter. / Predictors of pregnancy and live-birth in couples with unexplained infertility after ovarian stimulation–intrauterine insemination. In: Fertility and sterility. 2016 ; Vol. 105, No. 6. pp. 1575-1583.e2.
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AU - Engmann, Lawrence

AU - Diamond, Michael P.

AU - Legro, Richard S.

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AU - Alvero, Ruben

AU - Robinson, Randal D.

AU - Casson, Peter

AU - Christman, Gregory M.

AU - Huang, Hao

AU - Santoro, Nanette

AU - Eisenberg, Esther

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AU - Diamond, Michael Peter

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N2 - Objective To identify baseline characteristics of couples that are likely to predict conception, clinical pregnancy, and live birth after up to four cycles of ovarian stimulation with IUI in couples with unexplained infertility. Design Secondary analyses of data from a prospective, randomized, multicenter clinical trial investigating pregnancy, live birth, and multiple pregnancy rates after ovarian stimulation-IUI with clomiphene citrate, letrozole, or gonadotropins. Setting Outpatient clinical units. Patient(s) Nine-hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation clinical trial. Intervention(s) As part of the clinical trial, treatment was randomized equally to one of three arms and continued for up to four cycles or until pregnancy was achieved. Main Outcome Measure(s) Conception, clinical pregnancy, and live-birth rates. Result(s) In a multivariable logistic regression analysis, after adjustment for other covariates, age, waist circumference, income level, duration of infertility, and a history of prior pregnancy loss were significantly associated with at least one pregnancy outcome. Other baseline demographic and lifestyle characteristics including smoking, alcohol use, and serum levels of antimüllerian hormone were not significantly associated with pregnancy outcomes. Conclusion(s) While age and duration of infertility were significant predictors of all pregnancy outcomes, many other baseline characteristics were not. The identification of level of income as a significant predictor of outcomes independent of race and education may reflect differences in the underlying etiologies of unexplained infertility or could reveal disparities in access to fertility and/or obstetrical care. Clinical Trial Registration NCT01044862.

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