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Meta-Analysis
. 2017 Apr;295(4):1025-1032.
doi: 10.1007/s00404-017-4290-3. Epub 2017 Feb 14.

The effect of slow release insemination on pregnancy rates: report of two randomized controlled pilot studies and meta-analysis

Julian Marschalek  1 , Maximilian Franz  1 , Yael Gonen  2 , Jan-Steffen Kruessel  3 , Amnon Weichselbaum  4 , Lorenz Kuessel  1 , Marie-Louise Trofaier  1 , Johannes Ott  5
Affiliations
Meta-Analysis

The effect of slow release insemination on pregnancy rates: report of two randomized controlled pilot studies and meta-analysis

Julian Marschalek et al. Arch Gynecol Obstet. 2017 Apr.

Abstract

Purpose: A modified application technique of intrauterine insemination (IUI) is slow release insemination (SRI), first described by Muharib et al. (Hum Reprod 7(2):227-229, 1992), who postulated higher pregnancy rates with a slow release of spermatozoa for 3 h.

Methods: To investigate this approach, two randomized controlled, cross-over pilot studies were performed from 2004 to 2006 in Israel and Germany to compare SRI with the standard bolus IUI. We aimed to present the results and perform a meta-analysis on available data for SRI. Univariate comparisons of pregnancy rates were performed using one-tailed z tests for method superiority. For meta-analysis, a fixed-effect Mantel-Haentzel weighted average of relative risk was performed.

Results: Fifty treatment cycles (IUI: n = 25, SRI: n = 25) were performed in Germany, achieving four pregnancies (IUI: 4%, SRI: 12%, p > 0.05). Thirty-nine treatment cycles (IUI: n = 19, SRI: n = 20) were performed in Israel achieving six pregnancies (IUI: 10.5%, SRI: 20%; p > 0.05). Meta-analysis of all eligible studies for SRI (n = 3) revealed a combined relative risk for pregnancy after SRI of 2.64 (95% CI 1.04-6.74), p = 0.02).

Conclusions: In conclusion, these results lend support to the hypothesis that the pregnancy rate might be improved by SRI compared to the standard bolus technique.

Keywords: Infertility; Intrauterine insemination; Outcome; Pregnancy rate; Slow release insemination.

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Conflict of interest statement

Conflict of interest

Apart from non-financial support for statistical and editorial purposes, JM declares that he has no conflict of interest. MF declares that he has no conflict of interest. YG declares that she has no conflict of interest. JSK received grants for study design and data collection from Fertiligent Ltd. AW declares that he has no conflict of interest. LK declares that he has no conflict of interest. MLT declares that she has no conflict of interest. JO declares that he has no conflict of interest. The funding sources had no involvement in the decision to write or submit the article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Schematic illustration of IQI-100 syringe pump
Fig. 2
Fig. 2
Randomization and pregnancy rate of HHU and LIN patients
See this image and copyright information in PMC

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