The Relationship between Waist-to-Hip Ratio, Selected Immunological Markers, Follicular Parameters, and Endometrial Thickness with Intrauterine Insemination (IUI) Outcomes among Infertile Women in Kirkuk, Iraq

Background: Intrauterine insemination (IUI), whether administered with or without ovarian stimulation, is regarded as a first-line intervention among assisted reproductive technologies for the treatment of infertility. The growing success rates associated with this technique have led many infertile couples to consider it as a preferred initial therapeutic option. Aim of Sutdy: This study aimed to generate local data to evaluate the relationship between immunological markers—such as Tumor Necrosis Factor (TNF) and antiphospholipid antibodies (aPL)—as well as follicular parameters, endometrial thickness, and waist-to-hip ratio, with intrauterine insemination (IUI) outcomes. The ultimate goal was to improve infertility treatment strategies within the Iraqi community, particularly given the limited local research available in Kirkuk. Methods: The study involved 96 infertile women who underwent intrauterine insemination (IUI) from December 2023 to February 2025. The association between the variables and pregnancy rates was analyzed using appropriate statistical methods. Results: Significant differences in follicle size were observed between IUI responders and non-responders across all age groups except the oldest. Endometrial thickness on insemination day differed significantly only in the two older groups. Other variables—number of oocytes, TNF, aPL, and waist-to-hip ratio (WHR)—showed no significant differences across all ages. Conclusion: The pregnancy rate decreases with the reduction of both endometrial thickness and follicle size, which may reduce the effectiveness of IUI in women experiencing these conditions. Conclusion: IUI outcomes are influenced by immunological and physiological characteristics, necessitating the management of related conditions before proceeding with IUI treatment.