Intrauterine insemination in Jamaica as a low-cost subfertility treatment in a low-resource region.
OBJECTIVE
To determine the impact of intrauterine insemination on the management of subfertility in Jamaica.


METHODS
The present study was a retrospective analysis of all intrauterine insemination cycles completed from May 1, 2002, to August 31, 2005, at the University of the West Indies, Mona, Jamaica. The cycle pregnancy rate (CPR), live-birth rate (LBR), and cumulative pregnancy rate were obtained and prognostic factors were reviewed.


RESULTS
The CPR, LBR, and cumulative pregnancy rate were 10.1%, 8.8%, and 13.9%, respectively. Improved success was significantly associated with a shorter period of infertility (3.10 ± 1.43 years vs 5.22 ± 2.89 years; P = 0.01). Women younger than 40 years of age, men with increased post-preparation sperm counts, and couples undergoing 2-3 cycles had improved outcomes.


CONCLUSIONS
Intrauterine insemination represents a safe and cost-effective option for mild male factor infertility or unexplained infertility, especially in resource-poor regions such as the Caribbean. Repeated failed cycles identify those who would probably benefit from early intervention with in vitro fertilization.
Department of Obstetrics and Gynecology, University of the West Indies, Mona, Jamaica. loxleychristie@hotmail.com
Loxley R
LR
Christie
John A
JA
Harriott
Vernon E
VE
Dacosta
Shaun H
SH
Wynter
Denise M
DM
Everett
Rochelle A
RA
Foster
D000328:Adult; D003906:Developing Countries; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D007315:Insemination, Artificial / Q000191:economics* / Q000379:methods*; D007563:Jamaica; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome