A bibliographic review of double versus single homologous intrauterine insemination for male factor infertility

Abstract

Background: Double insemination in the same cycle is an attempt to improve the clinical pregnancy rates in couples undergoing intrauterine insemination for mild to moderate male factor infertility.

Objectives: To determine clinical pregnancy rates in double versus single intrauterine insemination in the same cycle with partner’s sperms in couples with mild to moderate male factor infertility.

Study design: A bibliographic review.

Method: Eligibility criteria: Randomized controlled trials comparing clinical pregnancy rates of double versus single intrauterine insemination in the same cycle with partner’s sperms in couples with mild to moderate male factor infertility.

Information source: PubMed/ Medline, Trip Medical Database, and Cochrane Library were searched for studies published in English language without year restriction by using keywords; double insemination, and artificial insemination in humans.

Risk of bias: Quality of trials was assessed using the Critical Appraisal Skills Programme for Randomized Controlled Trials (CASP RCT), 2020.

Results: A total 2331 participants or couples with mild to moderate male factor infertility were investigated in the eight studies reviewed. Majority of the studies reviewed, indicated a trend of increased clinical pregnancy rates in double compared to single intrauterine insemination. Clinical pregnancy rates in the studies reviewed ranged from 4-17.3% for single intrauterine insemination and 6.4- 30.4% for double intrauterine insemination.

Conclusion: Double intrauterine insemination may benefit infertile couples with mild to moderate male infertility as it is cheap, less invasive and has been shown to improve pregnancy rates compared to single intrauterine insemination.