The pregnancy rates with intrauterine insemination (IUI) in superovulated cycles employing different protocols (clomiphen citrate (CC), human menopausal gonadotropin (HMG) and HMG+CC) and in natural ovulatory cycle

Abstract

Objective: To compare the result of IUI in infertile couples with different protocols of induction ovulation.

Methods: In a retrospective study, 209 infertile couples with different diagnosis (unexplained, male factor, endometriosis, tubal disease, ovulatory dysfunction and multifactorial infertility) were subjected to different protocol of induction ovulation: 50-100 mg CC in day 2-6, 50 mg CC in day 2-6 + 2 amp HMG in day 5, 7, 9, 11, and 2 amp HMG per day. Natural ovulatory cycle + IUI was used for sperm stored patients. 441 consecutive cycles of IUI was performed 36-40 hours after HCG injection. The data were analysed with student T-test and Mann-Whitney test. The significance was defined as P<0.005.

Results: Thirty one pregnancies (7% per cycle, 15% per patient) occurred. One pregnancy occurred (pregnancy per cycle was 2% and per patient was 12%) in 8 patients undergoing 37 cycles of IUI with natural ovulation. The result with CC in 27 patients undergoing 41 cycles IUI was 2 pregnancies (4% per cycle, 7% per patient). In 129 patients receiving 283 cycles of IUI with CC+HMG 21 pregnancies occurred (7% per cycle, 16% per patient). In 35 patients receiving 80 cycles of IUI with HMG 8 pregnancies occurred (9% per cycle, 23% per patient).

Conclusion: The method chosen for ovulation induction had a critical bearing on the success of IUI. The result of IUI will be better by using induction ovulation compared to natural ovulatory cycle. In our programme the combined use of HMG+IUI yielded a higher rate of pregnancy rate compared with CC+IUI, CC+HMG+IUI and natural ovulatory cycle+IUI.