Article
Authors: Michelle Krohn (University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, Iowa City, Iowa) , Amy E.T. Sparks (University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Iowa City, Iowa) , Divya K Shah (University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Iowa City, Iowa)
Objective: To compare pregnancy rates between lean, overweight, and obese women with polycystic ovary syndrome (PCOS) undergoing ovulation induction-intrauterine insemination (OI-IUI).
Design: Retrospective cohort study
Setting: Academic training program
Patient(s): All women with PCOS undergoing OI-IUI from January 2000 to November 2013.
Interventions: Ovulation induction-intrauterine insemination with oral (oral OI-IUI) or combined oral and injectable (combined OI-IUI) agents.
Main Outcome Measures: Clinical pregnancy rates (CPR) per IUI were compared in 198 women undergoing oral OI-IUI and combined OI-IUI. Multivariate logistic regression was used to calculate the odds of clinical pregnancy while adjusting for potential confounders. Results were expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI), using lean women as the referent population.
Results: In lean PCOS patients undergoing combined OI-IUI, the unadjusted CPR was 52%; CPR was comparatively lower in overweight (22%), obese (27%) and morbidly obese (21%) women for all cycles. Adjusting for age and duration of infertility, the odds of clinical pregnancy after combined OI-IUI was significantly diminished in overweight (OR=0.27 CI=0.12-0.63), obese (OR=0.41, CI=0.20-0.83) and morbidly obese women (OR=0.33 CI=0.14-0.78) as compared to the lean PCOS referent. A similar but non-significant trend was identified in women undergoing oral OI-IUI.
Conclusion: Lean women with PCOS have a higher CPR after combined OI-IUI as compared to their overweight, obese, and morbidly obese counterparts. Patients with a lean PCOS phenotype may preferentially benefit from this treatment approach.
Keywords: Ovulation induction, intrauterine insemination, polycystic ovary syndrome, lean, overweight, body mass index
How to Cite: Krohn, M. , Sparks, A. E. & Shah, D. K. (2015) “Outcomes of ovulation induction-intrauterine insemination in lean, overweight, and obese women with polycystic ovary syndrome”, Proceedings in Obstetrics and Gynecology. 5(2). doi: https://doi.org/10.17077/2154-4751.1288