Title

Study Evaluating the Timing of Intrauterine Insemination in Relation to Positive Home Ovulation Prediction Kit
Randomized Controlled Trial Evaluating the Timing of Intrauterine Insemination in Relation to the LH Surge
  • Phase

    N/A
  • Study Type

    Interventional
  • Intervention/Treatment

    letrozole clomifene ...
  • Study Participants

    13
The aim of this study is to assess the impact of the timing of intrauterine insemination (IUI) in relation to the natural surge of luteinizing hormone (LH), as detected by home ovulation predictor kits, on pregnancy rates per treatment cycle. The study will take place at the offices of Midwest Fertility Specialists and include patients who have been independently recommended by their primary physician to undergo ovulation induction with clomiphene citrate (CC) or letrozole and IUI as therapy for infertility.
Intrauterine insemination is a procedure that is performed in the physician's office. During the procedure the sperm from the male partner are placed directly into the female partner's uterus around the time of ovulation (release of oocyte or egg). Ovulation predictor kits, available over the counter at pharmacies, test for the presence of luteinizing hormone in the urine. When the test result is a positive, it means the hormone is present in the urine. This is a sign of ovulation. Physicians typically choose to perform intrauterine insemination either the day of a positive ovulation test or the day after a positive ovulation test. The purpose of this study is to determine if the day when intrauterine insemination is performed influences the chance of becoming pregnant.
Study Started
Oct 31
2013
Primary Completion
Sep 30
2015
Study Completion
Sep 30
2015
Results Posted
Dec 09
2015
Estimate
Last Update
Dec 09
2015
Estimate

Procedure Intrauterine Insemination

Intrauterine insemination is either performed on the day the home ovulation predictor kit first turns positive or the day after the first positive.

Drug Clomiphene

Patient is to take clomiphene citrate during cycle days 3-7.

  • Other names: clomid

Drug Letrozole

Patient is to take letrozole during cycle days 3-7.

Day Of Active Comparator

This group takes either clomiphene or letrozole on cycle days 3-7 and then receives intrauterine insemination on the day the home ovulation predictor kit first turns positive.

Day After Active Comparator

This group takes either clomiphene or letrozole on cycle days 3-7 and then receives intrauterine insemination on the day after the home ovulation predictor kit first turns positive.

Criteria

Inclusion Criteria:

All couples consisting of male and female partner undergoing CC or letrozole cycle plus IUI at a single infertility center (Midwest Fertility Specialists)
The female partner must be aged 21-39
Infertile couples include those with a diagnosis(s) of unexplained infertility, mild male factor, ovulatory dysfunction, or anovulation
Evidence of a normal uterus and at least unilateral tubal patency on saline infusion sonogram or hysterosalpingogram within the last 2 years
Semen analysis for male partner must have minimal sperm concentration of 10 million per milliliter

Exclusion Criteria:

Recurrent miscarriages
Nursing mothers
Diagnoses of primary ovarian failure, diminishing ovarian reserve (as indicated by blood follicle stimulating hormone >10 milliInternationalUnits/mL and/or anti-mullerian hormone level <0.5), abnormal uterine bleeding of undetermined origin, ovarian cyst of undetermined origin, stage IV endometriosis, or sex-hormone dependent tumors
Documented bilateral tubal obstruction or other uncorrected uterine anomalies (e.g. uterine septum)
Previous gonadotropin use and/or previous treatment with in vitro fertilization
Abnormal semen analysis (sperm concentration less than 10 million per mL) or ejaculatory dysfunction in male partner
Other uncorrected medical condition in female partner that would be a contraindication to attempting elective ovulation induction (e.g., uncontrolled diabetes, intracranial lesion, thyroid or adrenal disease)

Summary

Insemination Day Of Positive OPK

Insemination Day After Positive OPK

All Events

Event Type Organ System Event Term

Number of Pregnancies Achieved Per Menstrual Cycle.

Insemination Day Of Positive OPK

Insemination Day After Positive OPK

Per Cycle Pregnancy Rate Based on Infertility Diagnosis

Insemination Day Of Positive OPK

Insemination Day After Positive OPK

Pregnancy Rate Per Female Partner Age

Pregnancy rate will be compared between patients <35 and >35 at time of study entry.

Insemination Day Of Positive OPK

Female age < 35

Female age > 35

Insemination Day After Positive OPK

Female age < 35

Female age > 35

Pregnancy Rate Per Semen Morphology Score

Comparison of pregnancy rate based on semen morphology of <4% vs >4% normal morphology scores.

Insemination Day Of Positive OPK

Semen morphology < 4%

Semen morphology > 4%

Insemination Day After Positive OPK

Semen morphology < 4%

Semen morphology > 4%

Pregnancy Rate Per Body Mass Index Category

Insemination Day Of Positive OPK

Body mass index normal

Body mass index obese

Body mass index overweight

Insemination Day After Positive OPK

Body mass index normal

Body mass index obese

Body mass index overweight

Total

13
Participants

Age, Continuous

30.1
years (Mean)
Standard Deviation: 4.8

Anti-mullerian Hormone

5.2
ng/ml (Mean)
Standard Deviation: 2.3

Body Mass Index

27.9
kg/m^2 (Mean)
Standard Deviation: 7.5

Day 3 Follicle Stimulating Hormone

6.9
mIU/ml (Mean)
Standard Deviation: 1.8

Mid-luteal progesterone

18.6
ng/ml (Mean)
Standard Deviation: 13.7

Sperm Concentration

39.4
million sperm/ml (Mean)
Standard Deviation: 30.9

Sperm morphology

6.2
Percent normal (Mean)
Standard Deviation: 2.6

Region of Enrollment

Sex: Female, Male

Overall Study

Insemination Day Of Positive OPK

Insemination Day After Positive OPK

Drop/Withdrawal Reasons

Insemination Day After Positive OPK