Intra-Uterine Insemination (IUI) outcome is enhanced by shorter intervals from semen collection to sperm wash, from sperm wash to IUI time, and from semen collection to IUI time

Abstract

Objective: To determine if IUI outcome was affected by: 1) place of semen collection (home vs. clinic); and 2) intervals from semen collection to sperm wash (C-SW), from sperm wash to IUI time (SW-IUI), and from semen collection to IUI time (C-IUI). Design: A retrospective analysis of IUI results from January 2000 to March 2003. Materials and Methods: In 132 IUI cycles, women with infertility of various causes received either clomiphene citrate (CC) or human menopausal gonadotropin (hMG). Women stimulated with CC received 50–250 mg/day for 5 days starting on cycle day 3; and women stimulated with hMG were started on cycle day 3, if a baseline ultrasound revealed no ovarian cyst. When the largest follicle(s) reached a mean diameter of 19 mm, ovulation was induced with 10,000 IU hCG, and a single IUI was performed 36–38 hours later. Women underwent IUI using their respective partners’ washed sperm obtained from ejaculates collected either at home (H), or at our clinic (FIRST, F). Ejaculates were allowed at least 15 minutes for liquefaction before sperm wash by a gradient density method. Pregnancy was defined as ultrasonographic detection of a fetal heart beat(s). Pregnancy data were analyzed by least squares analysis of covariance using the General Linear Models Procedure of Statistical Analysis System (SAS), with medication type (CC, hMG) and semen collection place (H, F) as treatments in a 2 x 2 factorial design, and age of women and the total number of progressively-motile spermatozoa as covariates. In a sub-group of 70 women, the intervals of C-SW, SW-IUI, and C-IUI were compared by Student’s t-test between: 1) collection places; and 2) pregnant and non-pregnant women within medication types. Results: Results are shown in the tables. Tabled 1∗a,b: P≤0.05 within treatments; ∗∗a,b,c: P≤0.05 Tabled 1Mean ± SEM; ∗Intervals in minutes ∗a,b: P≤0.05 within treatments; ∗∗a,b,c: P≤0.05 Mean ± SEM; ∗Intervals in minutes Conclusion: CC and hMG result in similar pregnancy rates when semen is collected either at home or at clinic. Semen collection at clinic results in higher pregnancy rate than at home both in CC- and hMG-treated women. Pregnancy is not affected by intervals of C-SW, SW-IUI, and C-IUI in CC-treated women, but is associated with shorter intervals in hMG-treated women. The study is ongoing, and updated results will be presented at the meeting.