Background: Intrauterine insemination overcomes sperm ascent barriers by depositing processed semen in the uterine cavity. The study aims to evaluate intravaginal hyaluronic acid's effect on endometrial receptivity using Doppler ultrasound and Uterine Biophysical Profile scores, and its role in enhancing pregnancy rates in IUI for infertile couples.
Methods: This comparative prospective study was conducted at the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, from September 2021 to May 2022. Forty-nine infertile couples were randomly selected and divided into Group A (n=27) and Group B (n=22). Group A received daily 5mg HA pessaries (Ialugyn) from cycle day 7 until day 21. Serial ultrasound examinations monitored follicular development. The Uterine Biophysical Profile was assessed on the day of IUI, and pregnancy outcomes were evaluated 14 days post-IUI for comparison.
Result: Demographic data and basal serum hormonal levels showed no significant differences (P>0.05) between groups. Uterine Biophysical Profile parameters remained unchanged. The total pregnancy rate was 18.3%, with no significant difference between study group (22.2%) and control group (13.6%), (p=0.440). The study group exhibited a higher pregnancy rate. A significant difference (p=0.042) in UBP was found between pregnant and non-pregnant women, with a cutoff value >16, 56% sensitivity, 72% specificity, 64% accuracy, and an AUC of 0.973.
Conclusions: Intrauterine insemination with intravaginal HA improves endometrial receptivity and pregnancy rates, evidenced by the positive impact on Uterine Biophysical Profile score. The limited sample size might account for the non-significant increase in pregnancy rate.