How Frequent Multi Follicular Response in Intra Uterine Insemination Cycle Leads to Multiple Pregnancy in Prolong Primary Subfertile Patient?

Previously published studies on multi follicular studies are not consistent. Intra uterine insemination (IUI) is a good treatment option for limited resource countries because of its cost effectiveness and easy accessibility in remote areas. We aimed to identify pregnancy determining factors of IUI following controlled ovarian stimulation among educated sub fertile women in Bangladesh. A cross sectional retrospective study was conducted at Fertility Center of Evercare Hospital Dhaka, Bangladesh from January 2016 to December 2018 where 518 IUI cycles performed after taking written consent from participants. A total of 426 couples medical records were analyzed on the basis of inclusion and exclusion criteria. ovarian stimulating agent like clomiphene citrate tablet and human menopausal gonadotropin (HMG) subcutaneous injection alone or combined has been given to every women under this study. While at least one follicle diameter reached 18 mm then intramuscular Human Chorionic Gonadotropin (HCG) was given and IUI procedure was performed after 36 hours later. While analyzing the data a higher mea n± SD was observed in pregnant groups than non-pregnant one regarding women’s age, BMI, their husband’s initial total motile sperm, inseminated harvested sperm and endometrial thickness though duration of married life was more in non-pregnant but these were not statistically significant. But the number of mature follicle was significantly higher in pregnant woman (P< 0.001). More than three follicle yield highest pregnancy than single or double follicles. Multi follicles showed a gradual decrease with age. A higher IUI was observed in woman with normal ovarian reserve. We propose that, IUI could be an effective therapeutic procedures for women with primary subfertility and could aid as an effective assisted reproductive technology in medical science.