The Relations Between HSG Proven Tubal Occlusion, Stimulated Intrauterine Insemination and Pregnancy Rate

Abstract

Background: Tubal factor infertility is one of the maincauses of female infertility. Although its sensitivity islow, hysterosalpingography (HSG) is remains the firstlinemethod for evaluating tubal patency.Aims: To compare pregnancy rates in patients with HSGproven proximal or distal unilateral tubal occlusion,and unexplained infertility undergoing both controlledovarian stimulation (COS) and intrauterine insemination(IUI).Study Design: Case control study.Methods: In total, 237 patients undergoing ovulationinduction (OI) with gonadotropins and IUI were dividedinto two groups and evaluated. Study group consisted 59patients with HSG proven unilateral tubal pathology, and178 patients with unexplained infertility taken as controlsubjects. Cumulative pregnancy rate was the primaryendpoint.Results: Cumulative pregnancy rates after three cyclesof OI and IUI were 15.25% in study group and 20.79%in control group. Pregnancy rates between two groupswere not statistically significant. Although, pregnancyrates in patients with proximal tubal occlusion (21.8%)were higher than in those with distal tubal occlusion(7.4%), the difference was not statistically significant.Conclusion: Our study data shows that, regardless ofthe HCG proven occlusion area, COS and IUI might bea preferred treatment modality in patient with unilateraltubal occlusion.