Intrauterine insemination after ovarian stimulation as a treatment for subfertility because of subnormal semen: A prospective randomized controlled trial

Abstract

Objective: To determine whether intrauterine insemination (IUI) after ovarian stimulation with human menopausal gonadotropin (hMG) gives a better pregnancy rate (PR) than natural intercourse in couples with subfertility because of subnormal semen. Design: Prospective randomized controlled trial. Setting: University based subfertility clinic. Patients: Couples with subnormal semen as the only identifiable cause of subfertility. Interventions: In control cycles, the couples had natural intercourse. In IUI cycles, IUI was performed after ovarian stimulation with hMG and human chorionic gonadotropin. Main Outcome Measure: The clinical PRs and complications of IUI cycles and control cycles were compared. Results: There were six clinical pregnancies in the 42 IUI cycles, whereas there was no clinical pregnancy in the 42 control cycles. The clinical PR in IUI cycles (14.3% per cycle) was significantly higher than that in control cycles (0%). Six patients (14.3%) developed moderate degree of ovarian hyperstimulation syndrome in IUI cycles. Conclusion: Intrauterine insemination after ovarian stimulation with hMG is useful in treatment of subfertile couples with subnormal semen.