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AIM- Is there any association of mean follicular diameter at the time of ovulation trigger with conception rate after Intrauterine Insemination?
METHODOLOGY- This was a prospective observational study conducted in department of Obstetrics and Gynaecology, AIIMS, Raipur from October 2019 to March 2021. All women who were planned for IUI after Ovulation Induction (with Clomiphene Citrate or Letrozole) and those who fulfilled the inclusion and exclusion criteria were enrolled for the study. Partner with TMSC >5 million was included. The first cycle that was conducted was selected for the study. All patients were followed up from day 2 of cycle. As per the standard protocol of IUI, Ovulation induction (with Clomiphene Citrate or Letrozole), serial follicular monitoring were done. Later, ovulation trigger was given. The Mean Follicular Diameter (MFD) at the time of ovulation trigger was noted and participants were divided into 4 groups:
Group A: MFD ≤ 18 mm
Group B: MFD 18- 20 mm
Group C: MFD 20-22 mm
Group D: MFD >22 mm
IUI was performed after 36 hours of hCG injection. Luteal phase support for next 14 days were given from the day of IUI. Urine Pregnancy Test (UPT) was advised after missed periods and result were noted.
OBSERVATION- Of the 73 undergone IUI, 9 (12.3%) became pregnant successfully. The average of MFD among the study subjects who conceived after IUI was 19.43. Maximum conception was observed in group with MFD 18.1-20 mm (17.1%) followed by MFD 20.1-22 mm (15%), whereas all the IUI recipients in < 18 mm and >22 mm groups did not conceive.
CONCLUSION- There may be an inverted U-shaped relationship between the MFD among the outcomes of IUI. However, the optimal MFD can be recommended between 18-22 mm for ovulation trigger with hCG for successful pregnancy outcome.
