71 IUI success and prognosis of natural conception 4 Tabel 1. Baseline characteristics of patients just before receiving HSG (n=975). Data are means (unless specified) or n (%) with the5th-95th percentile in brackets Couples who remained on expectant management (n=388) Couples who started IUI-OS within one and a half years (n=587) Female age (years) 32.7 (26.2-38.9) 32.9 (26.1-39.0) Duration of subfertility (years, median) 1.6 (0.9-4.3) 1.7 (0.9-4.0) Primary subfertility (versus secondary) 233 (60%) 426 (73%) Total motile sperm cell count (millions, median) 72 (4-304) 43 (4-294) One sided tubal pathologya (yes versus no) 16 (4%) 29 (5%) Referral by specialist (versus referral by general practitioner) 31 (8%) 60 (10%) a assessed by hysterosalpingography (HSG) or in addition, a later laparoscopy The predicted probability that a couple would conceive over the course of 6 months of expectant management after HSG was 29% (95% CI: 25–32%). If the couple started IUI-OS directly after HSG, their estimated probability of conception in the next six months was 40% (32–47%). Judging by a decrease of at least 2 points in terms of AIC, the relative effect of IUI-OS did not depend on the prognosis of natural conception (AIC decreased by 1 point, p=0.17). The relative effect of IUI-OS was dependent on how long after the HSG treatment it was started (AIC decreased by 2.8 points, p=0.08). The relations between prognosis, the start of treatment and the estimated treatment effect are visualized in Figure 2. The figure shows the 6-month cumulative probabilities of conception with and without starting IUI-OS for three different example couples with a prognosis to conceive naturally at completion of the fertility workup over the next year of 40% (Figure 2, left panel), 32% (Figure 2, middle panel) or 25% (Figure 2, right panel), which were updated over time when these couples fail consecutive natural cycles and start treatment later.
RkJQdWJsaXNoZXIy MTk4NDMw