The Effect of Baseline Ovarian Cyst on Pregnancy Outcomes in Ovulation Induction/Intrauterine Insemination Cycles

Objective: To determine the effects of a baseline ovarian cyst on ovulation induction/intrauterine insemination (OI/IUI) cycle outcomes. Methods: A retrospective cohort analysis of 270 patients and 461 OI/IUI cycles performed between 2011 and 2021 was performed. The exposure variable was a simple ap...

Full description

Saved in:
Bibliographic Details
Main Authors: Karen Bethel, Rachel Warwar, Suruchi Thakore, Emily G. Hurley
Format: Article
Language:English
Published: Mary Ann Liebert 2024-04-01
Series:Women's Health Reports
Subjects:
Online Access:https://www.liebertpub.com/doi/10.1089/whr.2023.0124
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850138737790418944
author Karen Bethel
Rachel Warwar
Suruchi Thakore
Emily G. Hurley
author_facet Karen Bethel
Rachel Warwar
Suruchi Thakore
Emily G. Hurley
author_sort Karen Bethel
collection DOAJ
description Objective: To determine the effects of a baseline ovarian cyst on ovulation induction/intrauterine insemination (OI/IUI) cycle outcomes. Methods: A retrospective cohort analysis of 270 patients and 461 OI/IUI cycles performed between 2011 and 2021 was performed. The exposure variable was a simple appearing ovarian cyst diagnosed at baseline ultrasound measuring ≥10 mm with an estradiol level <75 ng/mL. The primary outcome analyzed was an ultrasound-confirmed intrauterine pregnancy. Secondary outcomes included positive pregnancy test and live birth. Summary data were presented with percentages, mean (standard deviation), or median (interquartile range). Comparisons of dichotomous variables were performed with the chi-square test, and continuous variables were compared using t-test. Regression analysis was performed using a general linear model. p-Values <0.05 were considered statistically significant. Results: The clinical pregnancy rate was nominally higher in the group without a cyst present at baseline ultrasound compared with those cycles with a simple cyst present, but the difference was not statistically significant (45/300 [15%] vs. 15/161 [9.3%], risk ratio [RR] 0.63 [0.36, 1.1]). After adjusting for BMI ≥30 and age ≥35, there remained no significant difference in clinical pregnancy rate (adjusted RR 0.65 [0.37, 1.1]). Conclusion: Given the present data, it is reasonable to proceed with IUI in the case of a baseline simple ovarian cyst. However, this finding may have an impact on clinical pregnancy outcomes in OI/IUI, and further research on the topic is warranted. Although this study was underpowered with fewer cycles than needed to demonstrate a significant difference, the point estimate suggests that the difference in clinical pregnancy rate could be ∼35%.
format Article
id doaj-art-545f136f0e9447fa9263fa5da3c54fbd
institution OA Journals
issn 2688-4844
language English
publishDate 2024-04-01
publisher Mary Ann Liebert
record_format Article
series Women's Health Reports
spelling doaj-art-545f136f0e9447fa9263fa5da3c54fbd2025-08-20T02:30:31ZengMary Ann LiebertWomen's Health Reports2688-48442024-04-0151758110.1089/whr.2023.0124The Effect of Baseline Ovarian Cyst on Pregnancy Outcomes in Ovulation Induction/Intrauterine Insemination CyclesKaren Bethel0Rachel Warwar1Suruchi Thakore2Emily G. Hurley3University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.Division of Reproductive Endocrinology and Infertility, University of Cincinnati, West Chester, Ohio, USA.Division of Reproductive Endocrinology and Infertility, University of Cincinnati, West Chester, Ohio, USA.Division of Reproductive Endocrinology and Infertility, University of Cincinnati, West Chester, Ohio, USA.Objective: To determine the effects of a baseline ovarian cyst on ovulation induction/intrauterine insemination (OI/IUI) cycle outcomes. Methods: A retrospective cohort analysis of 270 patients and 461 OI/IUI cycles performed between 2011 and 2021 was performed. The exposure variable was a simple appearing ovarian cyst diagnosed at baseline ultrasound measuring ≥10 mm with an estradiol level <75 ng/mL. The primary outcome analyzed was an ultrasound-confirmed intrauterine pregnancy. Secondary outcomes included positive pregnancy test and live birth. Summary data were presented with percentages, mean (standard deviation), or median (interquartile range). Comparisons of dichotomous variables were performed with the chi-square test, and continuous variables were compared using t-test. Regression analysis was performed using a general linear model. p-Values <0.05 were considered statistically significant. Results: The clinical pregnancy rate was nominally higher in the group without a cyst present at baseline ultrasound compared with those cycles with a simple cyst present, but the difference was not statistically significant (45/300 [15%] vs. 15/161 [9.3%], risk ratio [RR] 0.63 [0.36, 1.1]). After adjusting for BMI ≥30 and age ≥35, there remained no significant difference in clinical pregnancy rate (adjusted RR 0.65 [0.37, 1.1]). Conclusion: Given the present data, it is reasonable to proceed with IUI in the case of a baseline simple ovarian cyst. However, this finding may have an impact on clinical pregnancy outcomes in OI/IUI, and further research on the topic is warranted. Although this study was underpowered with fewer cycles than needed to demonstrate a significant difference, the point estimate suggests that the difference in clinical pregnancy rate could be ∼35%.https://www.liebertpub.com/doi/10.1089/whr.2023.0124ovulation inductionintrauterine inseminationinfertilityovarian cyst
spellingShingle Karen Bethel
Rachel Warwar
Suruchi Thakore
Emily G. Hurley
The Effect of Baseline Ovarian Cyst on Pregnancy Outcomes in Ovulation Induction/Intrauterine Insemination Cycles
Women's Health Reports
ovulation induction
intrauterine insemination
infertility
ovarian cyst
title The Effect of Baseline Ovarian Cyst on Pregnancy Outcomes in Ovulation Induction/Intrauterine Insemination Cycles
title_full The Effect of Baseline Ovarian Cyst on Pregnancy Outcomes in Ovulation Induction/Intrauterine Insemination Cycles
title_fullStr The Effect of Baseline Ovarian Cyst on Pregnancy Outcomes in Ovulation Induction/Intrauterine Insemination Cycles
title_full_unstemmed The Effect of Baseline Ovarian Cyst on Pregnancy Outcomes in Ovulation Induction/Intrauterine Insemination Cycles
title_short The Effect of Baseline Ovarian Cyst on Pregnancy Outcomes in Ovulation Induction/Intrauterine Insemination Cycles
title_sort effect of baseline ovarian cyst on pregnancy outcomes in ovulation induction intrauterine insemination cycles
topic ovulation induction
intrauterine insemination
infertility
ovarian cyst
url https://www.liebertpub.com/doi/10.1089/whr.2023.0124
work_keys_str_mv AT karenbethel theeffectofbaselineovariancystonpregnancyoutcomesinovulationinductionintrauterineinseminationcycles
AT rachelwarwar theeffectofbaselineovariancystonpregnancyoutcomesinovulationinductionintrauterineinseminationcycles
AT suruchithakore theeffectofbaselineovariancystonpregnancyoutcomesinovulationinductionintrauterineinseminationcycles
AT emilyghurley theeffectofbaselineovariancystonpregnancyoutcomesinovulationinductionintrauterineinseminationcycles
AT karenbethel effectofbaselineovariancystonpregnancyoutcomesinovulationinductionintrauterineinseminationcycles
AT rachelwarwar effectofbaselineovariancystonpregnancyoutcomesinovulationinductionintrauterineinseminationcycles
AT suruchithakore effectofbaselineovariancystonpregnancyoutcomesinovulationinductionintrauterineinseminationcycles
AT emilyghurley effectofbaselineovariancystonpregnancyoutcomesinovulationinductionintrauterineinseminationcycles