title: Donor sperm insemination cycles: are two inseminations better than one?
abstract: The objective of this study was to determine the clinical pregnancy rate  with 2 inseminations compared to a single intrauterine insemination (IUI) in a  given cycle using frozen-thawed donor sperm. This was a retrospective study at  a university practice; patients were women using donor sperm. We conducted a  comparison of single IUI, intracervical insemination (ICI) followed by an IUI  on the next day, and double IUI (2 consecutive days); clinical pregnancy rate  was the main outcome measure. The cycle-specific and total pregnancy rates  were not significantly different between the 3 protocol groups (306 cycles).  The average pregnancy rate over 3 cycles was 10.2% for IUI, 15.3% for ICI/IUI,  and 13.7% for IUI/IUI (P = .47). After controlling for repeated  measures per subject and age, gravidity, and use of Clomid, there was no  significant difference between protocols. The ICI/IUI (odds ratio [OR] = 1.70;  95% confidence interval [CI], 0.83-3.51) and IUI/IUI (OR = 1.5; 95% CI,  0.52-4.33) protocols appeared more likely to result in a clinical  pregnancy than the single IUI protocol. Current information on the optimal  number of inseminations per cycle using donor sperm is limited. Our large  study using 3 protocols found an increase in pregnancy rate with the addition  of either an ICI or IUI to a single IUI protocol in a natural or Clomid cycle  but did not meet statistical significance. Additional prospective studies are  needed to better counsel patients using donor sperm.
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Diana E
authors.initials: DE
authors.lastname: Chavkin
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Molinaro
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Roe
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Anuja
authors.initials: A
authors.lastname: Dokras
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D007316:Insemination, Artificial, Heterologous / Q000379:methods*; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D055101:Semen Analysis; D012662:Semen Preservation; D013094:Spermatozoa; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene