Fallopian Tube Insemination as Outpatient Procedure
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- Category: Vol. 81, September 2013
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Fallopian Tube Insemination as Outpatient Procedure, WAEL S. NOSSAIR,; MOHAMMED S. FARAG and HEND S. SALAH
Abstract
Objective: To evaluate the efficacy of fallopian tube insemination in controlled ovarian hyperstimulation (COH) cycles.
Design: Prospective randomized study.
Setting: Ovulation induction program of according to protocols of controlled ovarian stimulation. At Zagazig Uni-versity Hospitals.
Zagazig University Hospital, Obstetrics and Gynecology Department, from Period between November 2011 to Novem-ber 2012.
Population: We studied 100 infertile women aged 18 to 40 years undergoing 100 cycles of COH (not include repeated cycle).
Methods: The inclusion criteria were; oligoatenospermia, patent at least one fallopian tube, one or more follicle with diameter between 18-24mm during foliclmetry. The exclusion criteria were; patient age more than 40 years, bilateral tubal block. All patient subjected to history taking, general exami-nation, routine laboratory evaluation, ultrasound evaluation and hysterosalpingography. Controlled ovarian hyperstimula-tion was achieved using of ovarian stimulation protocols: Clomiphene citrate (CC) and hMG (n=50) or hMG alone (n=40) or recombinant FSH (n=10). After computerized assisted semen analysis CASA and HSG, foliculometry was done to all patients with detection of follicle number, diameter of follicles ,endometrial thickness. Thirty-six hours after hCG administration, patients were subjected to fallopian tube insemination. Fallopian tube insemination was performed using a 4mL of sperm suspension after sperm preparation. The sperm preparation and IFI was done as outpatient proce-dure. Passive straightening of the uterus was used in all patients.
Main Outcome Measures: Validity (efficacy = feasibility) of the fallopian tube insemination method, chemical pregnancy, clinical pregnancy, incidence of complications (multiple pregnancies and ovarian hyperstimulation syndrome [OHSS]).
Results: The intra-fallopian tube insemination (I.F.I.) well tolerated by patients. The observed 25 clinical pregnancies (25%) of which 20 were ongoing (20%). The presence of more than one sac pregnancies was 10 (10%). No case of moderate or severe OHSS was observed in this study.
Conclusion: Results of this study indicate that the simple outpatient less costy method for intra-fallopian insemination is not only simple and reliable but also may lead to clinical pregnancy twice as high as standard IUI in COH cycles.