Efficacy of double intrauterine insemination in controlled ovarian hyperstimulation cycles.
OBJECTIVE
To investigate the effectiveness of double IUI and to determine the optimal timing of IUI in relation to hCG administration.


METHODS
Prospective randomized study.


METHODS
Infertility Center, Department of Obstetrics and Gynecology, University of Milan.


METHODS
Patients with male factor and unexplained infertility undergoing controlled ovarian hyperstimulation (COH) and IUI.


METHODS
After COH with clomiphene citrate and gonadotropins, patients were randomly assigned to one of the following groups: group A received a single IUI 34 hours after hCG administration, group B received a double IUI 12 hours and 34 hours after hCG administration, and group C received a double IUI 34 hours and 60 hours after hCG administration.


METHODS
Number of follicles > 15 mm in diameter on the day of hCG administration, number of motile spermatozoa inseminated, clinical pregnancy rate.


RESULTS
Two hundred seventy-three patients underwent 449 treatment cycles: 90 patients were treated for 156 cycles in group A, 92 patients for 144 cycles in group B, and 91 patients for 149 cycles in group C. The overall pregnancies rates for groups A, B, and C were 13 (14.4% per patient and 8.3% per cycle), 28 (30.4% per patient and 19.4% per cycle), and 10 (10.9% per patient and 6.7% per cycle), respectively. There was a statistically significant difference between group B and groups A and C.


CONCLUSIONS
Our data indicate that two IUIs performed 12 hours and 34 hours after hCG administration is the most cost-effective regimen for women undergoing COH cycles with clomiphene citrate and gonadotropins. Although the second insemination adds up to a slightly higher cost, it significantly increases the chance of pregnancy.
Ragni
G
G
Infertility Center, First Department of Obstetrics and Gynecology, University of Milan, Italy.
Maggioni
P
P
Guermandi
E
E
Testa
A
A
Baroni
E
E
Colombo
M
M
Crosignani
P G
PG
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D002996:Clomiphene / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007317:Insemination, Artificial, Homologous / Q000191:economics / Q000379:methods*; D008297:Male; D010053:Ovary / Q000187:drug effects / Q000502:physiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D011446:Prospective Studies
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D006062:Gonadotropins; D002996:Clomiphene