A randomized prospective comparison between intrauterine insemination and fallopian sperm perfusion for the treatment of infertility

Abstract

Objective: To determine if the pregnancy rates (PRs) in infertile women could be improved with fallopian sperm perfusion in comparison with IUI.

Design: Randomized prospective analysis.

Setting: Academically affiliated infertility center.

Patients: Consecutive patients undergoing controlled ovarian hyperstimulation (COH).

Interventions: After hCG administration, patients were randomized to either IUI or fallopian sperm perfusion.

Main outcome measures: Pregnancy rates with the two treatment modalities.

Results: Of 240 COH cycles, those randomized to IUI included 44 clomiphene citrate (CC) (group I) and 76 gonadotropin (group III) cycles. Patients receiving fallopian sperm perfusion included 44 cycles of CC (group II) and 76 cycles of gonadotropin (group IV) treatment. The overall PRs per cycle (10.8% versus 10.8%) were similar for IUI and fallopian sperm perfusion, respectively. The PRs were also similar when compared for ovulation induction with CC (6.8% versus 9.1%) and gonadotropins (13.2% versus 11.8%).

Conclusion: We conclude that fallopian sperm perfusion offers no advantage over IUI. Because the process of fallopian sperm perfusion is more time consuming and more costly (because of increased media usage), fallopian sperm perfusion does not seem indicated as a routine infertility therapy and should not replace IUI.