A prospective study of intrauterine insemination of processed sperm from men with oligoasthenospermia in superovulated women

A short period of ejaculatory abstinence before intrauterine insemination is associated with higher pregnancy rates

This study compared the effects of a dose of human chorionic gonadotropin (hCG) administration at the time of insemination on the reproductive outcome of estrus-synchronized Mongolian ewes subjected to two artificial insemination methods during the breeding season. All females were treated with a polyurethane intravaginal sponge impregnated with 45.00 mg of flurogestone acetate for 12 days, followed by an intramuscular injection of 330 IU of equine chorionic gonadotropin at sponge removal. In Experiment 1, 150 ewes were inseminated using a laparoscopic intrauterine artificial insemination method 48 hr after sponge removal. The ewes were randomly assigned to the hCG group which received 500 IU of hCG at the time of insemination, and the control group which received 1.00 mL of sterile saline solution. In Experiment 2, 85 ewes were inseminated twice at 48 and 60 hr after sponge removal using a cervical artificial insemination method. The ewes were randomly assigned to the hCG group, which received 500IU of hCG at the time of the first insemination and the control group which received 1.00 mL of sterile saline solution. The pregnancy rate in the control group was not significantly different compared to the hCG group in Experiment 1 and the pregnancy rate in the control group was significantly higher compared to the hCG group in Experiment 2. In conclusion, the administration of hCG at the time of insemination could not be recommended in ewes when implementing a fixed time artificial insemination protocol during the breeding season.

Treatment of ovulatory women with unexplained infertility with clomiphene citrate and intrauterine insemination: does dosage affect clinical pregnancy rate?

Ovarian stimulation in infertile women treated with the use of intrauterine insemination: a cohort study from China

Effectiveness of intrauterine insemination in subfertile couples with an isolated cervical factor: a randomized clinical trial

Aromatase inhibitors for infertility in polycystic ovary syndrome. The beginning or the end of a new era?

Use of clomiphene citrate in women

Follicular diameter and hCG administration do not affect pregnancy rates after clomiphene citrate and intrauterine insemination

Oocyte retrieval versus conversion to intrauterine insemination in patients with poor response to gonadotropin therapy

Performing two inseminations rather than one in intrauterine insemination cycles may not improve outcome

Controlled ovarian stimulation (COS) with intrauterine insemination (IUI) is an effective treatment in cases of cervical factor, unexplained infertility and mild male factor. The optimal timing of IUI after human chorionic gonadotrophin (hCG) after COS with clomiphene citrate is debatable and may be a factor limiting success of same. This study was designed to scientifically determine if variation in the timing of IUI could affect the cycle outcome. In a prospective randomized trial couples with mild male factor, unexplained infertility and mild endometriosis who underwent COS with IUI were recruited. COS was achieved with clomiphene citrate. Two hundred and four women underwent 461 cycles of IUI. Women were randomized to two groups: group I (104 patients, 231 cycles) had IUI 36 h after hCG, while group II (100 patients, 230 cycles) had IUI 24 h after hCG. Primary outcome included pregnancy rate per couple and per cycle. Fifty-four patients had pregnancy with and pregnancy rate per couple and per cycle were 32.6 and 14.7% in group I and 20 and 8.6% in group II, respectively (not statistically different). Altering timing of IUI after COS does not enhance pregnancy rates. IUI 36 h after hCG has marginally better pregnancy rates than 24 h. Timing of insemination may be kept at 24 or 36 h after hCG injection to suit the convenience of the clinic or care provider. The lack of statistical significance indicates need for larger studies to draw guidelines.

Prospective randomized trial comparing the effects of letrazole (LE) and clomiphene citrate (CC) on follicular development, endometrial thickness and pregnancy rate in patients undergoing super-ovulation prior to intrauterine insemination (IUI).

Artificial insemination with sperm is used to improve the chances of conception for various causes of infertility. Traditionally, sperm is deposited in or around the endocervical canal (cervical insemination - CI). Some studies reported higher pregnancy rates if sperm was deposited in the uterine cavity itself (intrauterine insemination - IUI), but most were uncontrolled. However the cost and the risks (infection and anaphylaxis) of IUI may also be higher. The objective of this review was to assess the effects of depositing donor sperm in the uterine cavity (intrauterine insemination) compared to cervical insemination. The Cochrane Subfertility Review Group specialised register of controlled trials was searched. Randomised trials comparing intrauterine insemination and cervical insemination, using fresh or cryopreserved semen, with or without ovarian hyperstimulation. Trial quality assessment and data extraction were done independently by two reviewers. Twelve studies were included. They comprised 697 patients undergoing 2215 treatment cycles. Ten trials used frozen semen, with three using ovarian hyperstimulation. Overall the methodological quality of the trials was low. The overall pregnancy rate per cycle in the intrauterine insemination group was 18% compared to 5% for cervical insemination. When cryopreserved donor sperm was used, the overall chance of pregnancy in spontaneous or clomiphene-corrected cycles was significantly higher with intrauterine insemination. This was irrespective of whether pregnancy rates were calculated on a per cycle (odds ratio 2. 63, 95% confidence interval 1.85 to 3.73) or per patient (odds ratio 3.86, 95% confidence interval 1.81 to 8.25) basis. The greatest benefit appeared in trials with poor pregnancy rates (less than 6%) for cervical insemination. There was no difference in pregnancy rate between intrauterine and cervical insemination when fresh donor sperm was used (odds ratio 0.90, 95% confidence interval 0.36 to 2. 24). Intrauterine insemination appears to be beneficial when cervical insemination using cryopreserved donor sperm has had low pregnancy rates. This applies to spontaneous, clomiphene corrected and gonadotrophin stimulated cycles. However it may offer little benefit where high pregnancy rates have been achieved with cervical insemination. There appears to be no additional benefit from intrauterine insemination when fresh sperm is used for donor insemination.

Artificial insemination with sperm is used to improve the chances of conception for various causes of infertility. Traditionally, sperm is deposited in or around the endocervical canal (cervical insemination - CI). Some studies reported higher pregnancy rates if sperm was deposited in the uterine cavity itself (intrauterine insemination - IUI), but most were uncontrolled. However the cost and the risks (infection and anaphylaxis) of IUI may also be higher. The objective of this review was to assess the effects of depositing donor sperm in the uterine cavity (intrauterine insemination) compared to cervical insemination. The Cochrane Subfertility Review Group specialised register of controlled trials was searched. Randomised trials comparing intrauterine insemination and cervical insemination, using fresh or cryopreserved semen, with or without ovarian hyperstimulation. Trial quality assessment and data extraction were done independently by two reviewers. Twelve studies were included. They comprised 697 patients undergoing 2215 treatment cycles. Ten trials used frozen semen, with three using ovarian hyperstimulation. Overall the methodological quality of the trials was low. The overall pregnancy rate per cycle in the intrauterine insemination group was 18% compared to 5% for cervical insemination. When cryopreserved donor sperm was used, the overall chance of pregnancy in spontaneous or clomiphene-corrected cycles was significantly higher with intrauterine insemination. This was irrespective of whether pregnancy rates were calculated on a per cycle (odds ratio 2.63, 95% confidence interval 1.85 to 3.73) or per patient (odds ratio 3.86, 95% confidence interval 1.81 to 8.25) basis. The greatest benefit appeared in trials with poor pregnancy rates (less than 6%) for cervical insemination. There was no difference in pregnancy rate between intrauterine and cervical insemination when fresh donor sperm was used (odds ratio 0.90, 95% confidence interval 0.36 to 2.24). Intrauterine insemination appears to be beneficial when cervical insemination using cryopreserved donor sperm has had low pregnancy rates. This applies to spontaneous, clomiphene corrected and gonadotrophin stimulated cycles. However it may offer little benefit where high pregnancy rates have been achieved with cervical insemination. There appears to be no additional benefit from intrauterine insemination when fresh sperm is used for donor insemination.

ObjectiveTo evaluate the impact of intrauterine insemination timing performed 24 or 36 h later following ovulation trigger on clinical pregnancy rate during ovulation induction with clomiphene citrate among infertile women was the objective of this study.MethodsThe medical records of 280 infertile patients who have underwent ovulation induction by using clomiphene citrate have been evaluated and cycle outcomes of the patients have been investigated specifically based on the timing of intrauterine insemination during the treatment cycle.ResultsThe clinical pregnancy rate of the study group based on the timing of intrauterine insemination (24 vs. 36 h following hCG trigger) was found to be similar regardless of infertility type. The cycle day of which hCG trigger has been performed was found to be significantly longer for patients who have achieved clinical pregnancy than patients who have not got pregnant following the treatment cycle. Dominant follicle diameter has not been found to affect clinical pregnancy rate during treatment cycles with clomiphene citrate.ConclusionsIn this study, intrauterine insemination timing did not affect the cycle outcomes whether the procedure has been performed 24 or 36 h later following ovulation trigger with exogenous hCG utilization. The longer period of treatment cycle during ovulation induction with clomiphene citrate resulted with higher clinical pregnancy rate. Intrauterine insemination can be done successfully at either 24 or 36 h after hCG in clomiphene citrate stimulated cycles. This will allow more flexibility and convenience for both physicians and patients, especially during weekends.