title: The effect of ovarian stimulation on the outcome of intrauterine insemination.
abstract: OBJECTIVE
  Although intrauterine insemination is one of the oldest techniques in reproductive medicine, its significance is still controversially discussed. Many factors have been reported as influencing pregnancy rates after IUI. The aim of this retrospective analysis is to evaluate the success rate of repeated inseminations depending on the type of ovarian stimulation.
  
  
  METHODS
  Patients who underwent intrauterine insemination in Wiesbaden Kinderwunschzentrum between 1998 and 2010, not older than 45 years of age, with male subfertility were included in this study. On the whole, 5,346 inseminations on 2,180 patients were analyzed retrospectively.
  
  
  RESULTS
  Females' mean age was 34.1, ranging from 19-45 years. In 433 cycles an insemination was performed during a natural cycle. 4,020 cycles were stimulated with recombinant FSH, 596 cycles with clomiphene, 194 with urinary FSH, 103 with HMG. The pregnancy rates range from 7.4% in the clomiphene group to 14.4% in the urinary FSH group. Clomiphene stimulation seems to offer the significantly lowest pregnancy rate (p = 0.03). The other types of stimulation do not differ significantly from each other concerning the pregnancy rate. Patients under 39 years of age do not profit from any ovarian stimulation. In 40 and more years of old patients, pregnancy rates are higher, if any stimulation was performed.
  
  
  CONCLUSIONS
  To sum up, clomiphene stimulation showed to offer significantly lower pregnancy rates in comparison to the natural cycle, FSH stimulation and HMG stimulation in IUI treatment. While women younger than 40 seem not to profit from any ovarian stimulation, women over 40 do profit.
authors.affiliation: Department of Obstetrics and Gynecology, Universitätsmedizin der Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
authors.forename: Ruth
authors.initials: R
authors.lastname: Gomez
authors.forename: Martin
authors.initials: M
authors.lastname: Schorsch
authors.forename: Joscha
authors.initials: J
authors.lastname: Steetskamp
authors.forename: Thomas
authors.initials: T
authors.lastname: Hahn
authors.forename: Kristina
authors.initials: K
authors.lastname: Heidner
authors.forename: Rudolf
authors.initials: R
authors.lastname: Seufert
authors.forename: Christine E
authors.initials: CE
authors.lastname: Skala
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D006801:Humans; D007315:Insemination, Artificial / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene; D005640:Follicle Stimulating Hormone