Therapeutic donor insemination: a prospective randomized study of scheduling methods

Abstract

Objective: To compare basal body temperature (BBT) graphs and urinary luteinizing hormone (LH) monitoring in scheduling therapeutic donor insemination.

Design: Participants were prospectively randomized to the BBT or LH groups.

Setting: Participants were private patients of the Reproductive Endocrine Division at Washington University School of Medicine.

Patients: Inclusion criteria were designed to assure an isolated male factor. Seventy-four of 113 patients completed the study; 18 had ongoing treatment at the end of the study.

Interventions: Basal body temperature graphs were physician interpreted and appointments prospectively chosen. Luteinizing hormone patients monitored daily urine samples and scheduled an appointment the day after the detected surge.

Main outcome measures: Fecundity rates, cumulative pregnancy rates, and cost per pregnancy were all prospectively evaluated.

Results: Life table analysis yielded a 6-month cumulative probability of pregnancy of 36.3% in the LH group and 65.1% in the BBT group (P less than 0.025). The total cost per pregnancy was lower in the BBT group (+6,212 versus +3,997; P less than 0.001).

Conclusions: This randomized prospective study demonstrates significant therapeutic and economic advantages when therapeutic donor insemination is prospectively scheduled by BBT graphs.