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ORIGINAL ARTICLE |
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Volume 24 |
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Number 1 |
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Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
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ORIGINAL ARTICLE |
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Volume 24 |
January - March 2008 |
Number 1 |
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The effect of atmospheric temperature on the
outcome of intrauterine inseminationNikbakht Roshan1, Saharkhiz Nasrin2, Ghalambor Dezfouli Fatemeh3
ABSTRACT
Objective: The aim of the study was to determine the effect of temperature on the outcome of intrauterine insemination (IUI), if any.
Methodology: In this prospective study, 274 and 294 cycles of Intra Uterine Insemination (IUI) were done at two different time of the year (2005-2006), in the cold and hot weather. The minimum and the maximum range of temperature in the cold weather were 3°C to 17°C and 13°C to 27°C and in the hot weather were 25°C to 32°Cand 43°C to 50°C respectively. The selected infertile couples were male factor infertility with abnormal parameters of semen, sexual dysfunction and abnormal post coital test and ovulatory factor and unexplained infertility. Pregnancy was confirmed by serum Beta HCG.
Results: Among 274 cycles in the cold weather, 24 patients got pregnant, (PR/cycle =8.75%) and among 294 cycles in the hot weather 18 patients were pregnant, (PR/cycle =6.12%) (P=0.23) There was no significant correlation between temperature and the outcome of IUI.
Conclusion: The finding of the study shows that the outcome of IUI is not influenced by temperature and weather is if no importance for IUI.
KEY WORDS: Temperature, IUI, Infertility.
Pak J Med Sci January - March 2008 Vol. 24 No. 1 127-129
1. Nikbakht Roshan, MD,
2. Saharkhiz Nasrin, MD
3. Ghalambor Dezfouli Fatemeh, MD,
1-3: IVF ward,
Imam Khomeini Hospital,
Jundishapur University of Medical Sciences,
School of Medicine,
Ahwaz – Iran.
Correspondence
Dr. Nikbakht Roshan, MD
E-mail: rosnikba@yahoo.com
* Received for Publication: June 8, 2007
* Revision Received: June 28, 2007
* Revision Accepted: November 3, 2007
INTRODUCTION
Infertility is a common problem, affecting up to 15 percent of couples. In an attempt to improve conception rate, artificial insemination techniques in various forms have been practiced for almost 200 years.
1,2Recently, intrauterine insemination (IUI) alone or in combination with controlled ovarian hyper stimulation (COH) has been practiced with hopes of better out come. Indications for therapeutic insemination with husband / donor sperm are male factor, cervical factors and unexplained infertility. The likelihood for success with IUI depends on the age of women, ovulatory cycles, sperm density, motility and morphology. The results of IUI with husband’s sperm are 3-15% per cycle.
2 Pronounced and persistent seasonal patterns in fertility are observed in virtually all human populations.3Monthly birth and temperature data for a variety of states and countries are used to estimate the effect of temperature fluctuations on fertility. Summer temperature extremes reduce conception in the southern United States, explaining a substantial part of the observed seasonal birth pattern; extreme cold shows no evidence of affecting conceptions.
4 Controls for monthly temperature do not explain the persistent spring peak in births in northern Europe. This finding suggests that other factors play an important role.3The influence of latitude and cloud cover on the seasonality of human birth was studied and sub study results support the hypothesis that human birth seasonality may be influenced by environment light intensity and photoperiod.
5 In a study it does not show any decrease in the fertility of pot room workers exposed to heat and static magnetic fields, when compared to other workers in the aluminum producing industry.6There are different results of the effect of temperature on the conception. Thus this study was an attempt to find the effect of temperature on the conception based on the relationship between variation of temperature and IUI outcome.
METHODOLOGY
Between November 2005 to September 2006, sub fertile patients with an indication for IUI attending the IVF center-university hospital were recruited for the study. The selected time of performing of IUI was based on the coldest and hottest part of the year in the region. In the cold of temperature, 22 November to 19 February 2005, the minimum of the temperature was 3
oc to 17oc and the maximum was 13oc to 27oc. In the hot weather, 15 June to 6 September 2006, the minimum of the temperature was 25oc to 32oc and the maximum was 43oc to 50oc.Couples were included with male factor infertility due to abnormal parameters of semen, sexual dysfunction, unexplained infertility with history of 3 to 6 times of ovulatory induction, poor post coital test and ovulatory factor infertility with history of 3 to 6 times of ovulation induction.
Patients under went controlled ovarian hyper stimulation they received clomiphen citrate and at least 75 IU HMG irrespective of whether they were ovulatory or anovulatory. In all of cycles, HCG (5000IU IM) was administered when at least a follicle reached a mean diameter of 18mm. Raw semen was processed for IUI using swim up technique and a single IUI was performed 36 hours later. If patient missed the period, serum B-HCG was performed. If serum B-HCG was positive, the result of IUI was positive.
Statistical Analysis: Data was expressed as the mean standard error of mean (SEM). Patients were matched on the basis of parameters of semen included the percent of the normal sperm morphology (<5%, 5-10% and >10%) and total motile count (5 x10
6, 5-10x106 and >10x106), age of women and ovulatory cycles. Student’s chi-square test was used. Statistical significance was set at P<0.05.RESULTS
The study comprised 371 couples who under went 568 IUI treatment cycles. Demographic characteristics of couples included in the study are shown in Table-I.
The age range of women and men were 16-24 years, 19-73 years respectively, and the range of duration of infertility was 7-264 months. Patients presented with primary and secondary infertility 77.7%, 22.3% respectively. Two hundred-seventy-four IUI cycles was done in the cold weather and 294 IUI cycles was performed in the hot weather. In the cold weather 24 patients become pregnant, the overall pregnancy rate (PR) was 24/274(8.75%) per cycles, and in the hot weather 18 patients were pregnant, PR was 18/294(6.12%) per cycle (P=0.23).
DISCUSSION
The rate of temperature of weather does not significantly affect IUI out come. Few studies have retrospectively examined the effect of temperature on the IUI out come. Proctor JG et al published a retrospective study and concluded that seasonality alters sperm motility parameters as well as morphology, but these changes are not significant enough to alter pregnancy rates.
7Interpretation of the study led to that spontaneous conception is independent of the weather, that Mur JM et al confirmed it, but no other studies.
4,6 Studies show that overall pregnancy rate per IUI cycle was 7.3% that same as the range of the other studies (3-15%).Acknowledgement
The authors wish to thank Mrs. Mitra Shabab and IVF Ward personnel for their assistance.
REFERENCES
1. Speroff L, Fritz MA. Male Infertility. Clinical Gynecologic Endocrinologic and Infertility. Speroff L, Fritz MA. (Seventh edition). Philadelphia, Willams & Wilkins 2005;1156-7.
2. Chimote M, Chimote N. Intraauterine Insemination. The Infertility Manual. (2nd edition). Rao KA, Brinston PR, Sathananthan AH. New Delhi, in Jaypee Brothers 2004;353-8.
3. Lam DA, Miron JA. Global patterns of seasonal variation in human fertility. Ann NY Acad Sci 1994;709:9-28.
4. Lam DA, Miron JA. The effects of temperature on human fertility. Demography 1996;33(3):291-305.
5. Cummings DR. The influence of latitude and cloud cover on the seasonality of human births. Soc Biol 2003;50(1-2):23-41.
6. Mur JM, Wild P, Rapp R, Vautrin JP, Coulon JP. Demographic evaluation of the fertility of aluminum industry workers: Influence of exposure to heat and static magnetic fields. Hum Reprod 1998;13(7):2016-19.
7. Proctor JG, Blackhurst DW, Boone WR. Does seasonality alter intrauterine insemination outcomes: A 5-year study? J Assist Reprod Genet 2004;21(7):263-70.
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