Vol. 6, Issue 1, Part A (2024)

Background: Intrauterine Insemination (IUI) that is the simplest form of ART remains widely used and affordable treatment for infertility among the populations of developing countries. However, implantation still plays an important role which determines the success rates of IUI or IVF cycles. Implantation outcome is dependent on quality of the embryo, quality of the endometrium, and quality at the level of maternal-fetal interface. To improve implantation and therefore subsequently the CPR various strategies have been investigated including targeting of different local embryonal signals. For example, implantation has been studied with the help of autologous platelet-rich plasma (PRP) that is introduced via intrauterine infusion (IUIF). There is perhaps no other signal as important and as widely acknowledged as hCG or human chorionic gonadotropin.

Aim of study: The objective of this study was to assess if the use of hCG with a concentration of 1000 IU in the process of flushing before the IUI procedure will improve the pregnancy rate in sub fertile women who are candidates for IUI treatment.

Material and Methods: In the period from November 2020 to May 2022, an empirical research was performed among 140 women with infertility problems and receiving treatment in a private clinic. These women agreed to be subjected into ovarian stimulation according to their response and were booked for intrauterine insemination (IUI) treatment at the clinic. It was possible to monitor the follicles using a special ultrasound and as soon as the largest follicle considered to be 17-19 mm, subcutaneous hCG was prescribed to encourage ovulation. The ladies of both groups underwent IUI treatment 36-38 hours after the hCG injection; ultrasound confirmed that ovulation had occurred. The women of study included in this analysis received either hCG 1000 IU gently flushed (for 3-5 minutes) through the IUI catheter for 70 of the women or no intervention for the control population.

Results: The results of the study suggest that there were no significant variations in the initial traits, reasons for undergoing IUI, fundamental menstrual cycle traits, and ovarian stimulation traits between the study group and the control group. However, there was a significant distinction between the two groups in terms of the causes of infertility, progesterone levels on the day of trigger, as well as the biochemical and clinical pregnancy rates.

Conclusion: The application of human chorionic gonadotropin (hCG) directly into the endometrial lining within 3-5 minutes before intrauterine insemination (IUI) can increase both biochemical and clinical pregnancy rates in IUI cycles, according to research.