title: Double vs. single intrauterine insemination per cycle: use in gonadotropin cycles and in diagnostic categories of ovulatory dysfunction and male factor infertility.
abstract: OBJECTIVE
  To evaluate the effectiveness of offering double intrauterine insemination (IUI) to clients in our fertility program.
  
  
  METHODS
  In this prospective, nonrandomized study, 595 couples with ovulatory dysfunction, endometriosis, male factor, unexplained, tubal factor and combined diagnoses utilizing clomiphene citrate-hCG (CC-hCG), CC-gonadotropin-hCG (CC-Gn-hCG), Gn-hCG, lupron-Gn-hCG (L-Gn-hCG) or luteinizing hormone (LH) surge monitoring of natural cycles were offered single or double IUI in a total of 1276 cycles. Single IUIs were performed at 36 hours following hCG or the day following LH surge; double IUIs were performed 18 and 36 hours following hCG or the day of and day following LH surge. Single versus double IUI clinical pregnancy outcomes were compared between ovarian stimulation protocols and diagnostic categories.
  
  
  RESULTS
  One hundred ten clinical pregnancies occurred for 508 couples in 999 single IUI cycles (fecundity, 11.0%); 45 clinical pregnancies for 174 couples occurred in 277 double IUI cycles (16.2%, p < 0.004). The single IUI group was younger than the double IUI group (32.8 vs. 33.7, p < 0.004). Differences for fecundity were noted regarding diagnostic categories between single and double IUI groups (ovulation dysfunction, 12.9% vs 19.5%, p < 0.048, and male factor, 7.9% vs. 17.5%, p < 0.030) and ovulation protocols (CC-Gn-hCG, 13.0% vs. 21.3%, p < 0.031, and L-Gn-hCG, 4.2% vs. 25.0%, p < 0.002).
  
  
  CONCLUSIONS
  Double IUI is superior to single IUI overall, especially when comparing Gn-containing ovarian stimulation protocols or within the ovulatory dysfunction and male factor diagnostic categories.
authors.affiliation: Department of Obstetrics and Gynecology, Box 70569, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614-1707, USA. randall@mail.etsu.edu
authors.forename: Gary W
authors.initials: GW
authors.lastname: Randall
authors.forename: Pickens A
authors.initials: PA
authors.lastname: Gantt
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D006801:Humans; D007246:Infertility; D007315:Insemination, Artificial; D007986:Luteinizing Hormone / Q000008:administration & dosage; D008297:Male; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D019836:Preimplantation Diagnosis / Q000379:methods; D011446:Prospective Studies
chemical_list: D005300:Fertility Agents, Female; D007986:Luteinizing Hormone