title: The successful use of hyperstimulated washed therapeutic donor insemination after standard therapeutic donor insemination has failed.
abstract: OBJECTIVE
  To investigate whether an aggressive therapeutic donor insemination regimen (stimulated folliculogenesis and ovulation plus intrauterine insemination) can produce a better fecundability rate than a more traditional insemination regimen (non-stimulated folliculogenesis plus LH-timed intracervical insemination) in women who have failed to become pregnant during an initial series of six traditional insemination cycles.
  
  
  METHODS
  A retrospective comparison of fecundability rates was undertaken between women undergoing the traditional insemination protocol and those who voluntarily switched to ovarian hyperstimulation coupled with intrauterine insemination.
  
  
  METHODS
  Eight-two women who failed to become pregnant during an initial series of six intracervical insemination cycles.
  
  
  RESULTS
  Fecundability was 5.6% in cycles of continued urinary LH-timed intracervical insemination and 19.4% when the more aggressive regimen was applied. The difference in fecundability between protocols was significant (P < .005).
  
  
  CONCLUSIONS
  After an initial series of donor inseminations has failed, a more aggressive insemination regimen involving ovarian hyperstimulation followed by washed intrauterine insemination provides a higher fecundability rate than continued intracervical insemination.
authors.affiliation: Department of Obstetrics and Gynecology, Medical School, University of Wisconsin, Madison, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Dow
authors.forename: J M
authors.initials: JM
authors.lastname: Jones
authors.forename: D A
authors.initials: DA
authors.lastname: Dumesic
authors.forename: Y
authors.initials: Y
authors.lastname: Lu
authors.forename: S S
authors.initials: SS
authors.lastname: Shapiro
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000494:pharmacology; D002996:Clomiphene / Q000494:pharmacology; D015331:Cohort Studies; D015925:Cryopreservation; D005260:Female; D005298:Fertility / Q000187:drug effects; D005300:Fertility Agents, Female / Q000494:pharmacology*; D006801:Humans; D007316:Insemination, Artificial, Heterologous / Q000379:methods*; D008596:Menotropins / Q000494:pharmacology; D010053:Ovary / Q000187:drug effects* / Q000502:physiology; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012662:Semen Preservation
chemical_list: D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D002996:Clomiphene; D008596:Menotropins