Skip to main content
Top

Open Access 18-04-2024 | Intrauterine Insemination | Assisted Reproduction Technologies

Rescue intrauterine insemination in women failing to retrieve oocytes at ovum pick-up: report of a case series

Authors: Ludovico Muzii, Giulia Galati, Ilenia La Barbiera, Antonella Linari, Oriana Capri, Daniela Pietrangeli, Edgardo Somigliana

Published in: Journal of Assisted Reproduction and Genetics

Login to get access

Abstract

Purpose

Failure to collect oocytes at the time of oocyte pick-up is an unfavorable outcome of in vitro fertilization (IVF) cycles. In these cases, prompt intrauterine insemination (IUI) could be an option (rescue IUI), but this possibility has been poorly studied.

Methods

Rescue IUI is routinely offered in our unit in women failing to retrieve oocytes, provided that they have at least one patent tube, normal male semen analysis, and the total number of developed follicles is ≤ 3. We therefore reviewed all oocyte retrievals performed from 2006 to 2022 in our unit to identify these cases. As a comparator, we referred to preplanned IUI performed during the same study period. The 95% confidence interval (95% CI) of proportions was calculated using a binomial distribution model.

Results

Rescue IUI was performed in 96 out of 3531 oocyte retrievals (2.7%; 95% CI 2.2–3.3%). Six live births were obtained, corresponding to 6.2% (95% CI 2.3–13.1). All pregnancies were singletons.

Conclusions

Rescue IUI in women failing to retrieve oocytes is a possible option that may be considered in selected cases. The efficacy is low, but the procedure is simple, and without significant risks. Generalizability to a conventional IVF protocol setting is however limited.
Literature
4.
go back to reference World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: Switzerland WHO Press; 2021. World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: Switzerland WHO Press; 2021.
5.
go back to reference World Health Organization. WHO laboratory manual for the examination and processing of human semen. 5th ed. Geneva: Switzerland WHO Press; 2010. World Health Organization. WHO laboratory manual for the examination and processing of human semen. 5th ed. Geneva: Switzerland WHO Press; 2010.
6.
go back to reference World Health Organization. WHO laboratory manual for the examination of human semen and semen cervical mucus interaction. 4th ed. Cambridge: World Health Organization. Cambridge University Press; 1999. World Health Organization. WHO laboratory manual for the examination of human semen and semen cervical mucus interaction. 4th ed. Cambridge: World Health Organization. Cambridge University Press; 1999.
7.
go back to reference Ragni G, Caliari I, Nicolosi AE, Arnoldi M, Somigliana E, Crosignani PG. Preventing high-order multiple pregnancies during controlled ovarian hyperstimulation and intrauterine insemination: 3 years’ experience using low-dose recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists. Fertil Steril. 2006;85(3):619–24. https://doi.org/10.1016/j.fertnstert.2005.09.021.CrossRefPubMed Ragni G, Caliari I, Nicolosi AE, Arnoldi M, Somigliana E, Crosignani PG. Preventing high-order multiple pregnancies during controlled ovarian hyperstimulation and intrauterine insemination: 3 years’ experience using low-dose recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists. Fertil Steril. 2006;85(3):619–24. https://​doi.​org/​10.​1016/​j.​fertnstert.​2005.​09.​021.CrossRefPubMed
8.
go back to reference Ferraretti AP, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L, ESHRE working group on Poor Ovarian Response Definition. ESHRE consensus on the definition of “poor response” to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26(7):1616–24.CrossRefPubMed Ferraretti AP, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L, ESHRE working group on Poor Ovarian Response Definition. ESHRE consensus on the definition of “poor response” to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26(7):1616–24.CrossRefPubMed
9.
go back to reference Immediata V, Patrizio P, Parisen Toldin MR, Morenghi E, Ronchetti C, Cirillo F, Baggiani A, Albani E, Levi-Setti PE. Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success. J Assist Reprod Genet. 2020;37(5):1195–201.CrossRefPubMedPubMedCentral Immediata V, Patrizio P, Parisen Toldin MR, Morenghi E, Ronchetti C, Cirillo F, Baggiani A, Albani E, Levi-Setti PE. Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success. J Assist Reprod Genet. 2020;37(5):1195–201.CrossRefPubMedPubMedCentral
10.
go back to reference Zippl AL, Wachter A, Rockenschaub P, Toth B, Seeber B. Predicting success of intrauterine insemination using a clinically based scoring system. Arch Gynecol Obstet. 2022;306(5):1777–86.PubMedPubMedCentral Zippl AL, Wachter A, Rockenschaub P, Toth B, Seeber B. Predicting success of intrauterine insemination using a clinically based scoring system. Arch Gynecol Obstet. 2022;306(5):1777–86.PubMedPubMedCentral
14.
go back to reference Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Hum Reprod. 2011;26(7):1768–74.CrossRefPubMed Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Hum Reprod. 2011;26(7):1768–74.CrossRefPubMed
Metadata
Title
Rescue intrauterine insemination in women failing to retrieve oocytes at ovum pick-up: report of a case series
Authors
Ludovico Muzii
Giulia Galati
Ilenia La Barbiera
Antonella Linari
Oriana Capri
Daniela Pietrangeli
Edgardo Somigliana
Publication date
18-04-2024
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-024-03091-z