[Analysis of factors associated with clinical pregnancy outcomes of IUI in advanced-age and young women].

Objective

To investigate the association between various factors and clinical pregnancy outcomes of intrauterine insemination (IUI) in both young and advanced-age women.

Methods

This retrospective cohort analysis examined a total of 16 884 IUI cycles performed in Peking University Third Hospital between January 2017 and December 2022. The women were categorized into two groups based on age: the advanced-age group (≥35 years) and the young group (<35 years). Multivariate logistic regression models adjusted for confounders were conducted.

Results

In the young group, anti-Müllerian hormone level (OR=1.050, 95%CI: 1.028-1.072, P<0.001), and cycle type (natural cycle vs ovarian stimulation cycle; OR=0.682, 95%CI: 0.578-0.806, P<0.001) were independent predictors of clinical pregnancy. In the advanced-age group, age (OR=0.932, 95%CI: 0.879-0.988, P=0.018), duration of infertility (OR=0.938, 95%CI: 0.893-0.985, P=0.011) and total progressive motile sperm count (TPMSC; OR=1.018, 95%CI: 1.002-1.034, P=0.028) were identified as independent predictors of clinical pregnancy.

Conclusions

For women under 35 years old, ovarian stimulation is a favorable independent predictor of clinical pregnancy rate in IUI cycles, and its use could significantly improve clinical pregnancy outcomes. In contrast, for advanced-age women (≥35 years), only younger age, shorter duration of infertility and higher TPMSC are the primary positive independent predictors, and ovarian stimulation cannot be established as a viable strategy to improve pregnancy outcomes, thus a more proactive assisted reproductive treatment should be adopted.