Vaginal misoprostol enhances intrauterine insemination.
This study examined whether the prostaglandin E(1) analogue misoprostol (400 microgram), when placed vaginally at the time of intrauterine insemination (IUI) improves pregnancy rates. A prospective, placebo-controlled, randomized and double-blind study involving 274 women in 494 IUI cycles resulted in a total of 64 pregnancies (13% per cycle). Misoprostol cycles totalled 253, with 43 pregnancies (17% per cycle), whereas placebo cycles totalled 241, with 21 pregnancies (9% per cycle). The cumulative pregnancy rate with misoprostol treatment was significantly greater than with placebo (P = 0.004, Cox proportional hazards regression). The benefit of misoprostol was seen in clomiphene cycles (14 versus 4%, P = 0.006), and was indicated in FSH cycles (33 versus 15%, borderline significance) and natural cycles (15.6 versus 7.7%, not significant), but was not seen in clomiphene/FSH cycles (18.2 versus 23.5%, not significant). Misoprostol treatment did not increase pain score on the day of IUI (1.1 versus 1.4) and at 1 day post IUI (0.6 versus 0.8). Complications were rare in both groups [six (2%) subject cycles in the misoprostol cycles compared with two (1%) in the placebo group]. It is concluded that the use of vaginal misoprostol may improve the chance for pregnancy in women having IUI in a wide variety of cycle types.
Brown
S E
SE
Department of Obstetrics and Gynecology, The Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA. sambrown99@yahoo.com
Toner
J P
JP
Schnorr
J A
JA
Williams
S C
SC
Gibbons
W E
WE
de Ziegler D
Oehninger
S
S
D000282:Administration, Intravaginal; D000328:Adult; D005260:Female; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007316:Insemination, Artificial, Heterologous; D007317:Insemination, Artificial, Homologous; D008297:Male; D016595:Misoprostol / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome
D016595:Misoprostol