Intrauterine insemination in ovulatory infertile patients

Abstract

Aim: Although there are many studies in literature comparing intrauterine insemination (IUI) and timed intercourse, there are only a few studies examining the use of clomiphene citrate (CC) in ovulatory infertile patients. The aim of this study was to compare IUI following CC‑induced ovulation and timed intercourse following CC‑induced ovulation in ovulatory infertile patients.

Methods: Hundred patients who had IUI or timed intercourse following ovulation induction (OI) via CC between 2012 and 2014 are prospectively scanned. Both groups were consisted of 50 patients. Both in groups 1 and 2 patients, the treatment with clomiphene citrate was started on the 3^rd day of the menstrual cycle with a dose of 50 mg/day and was continued for 5 consecutive days. On the 13^th day of the cycle, the patients were called for examination and folliculometry tests were performed via transvaginal ultrasonography. Human chorionic gonadotropin (HCG, a prepared syringe containing 250 μg/0.5 ml [6,500 IU equivalent] choriogonadotropin alpha) was given to all patients with a sufficient size follicle (18–20 mm). Group 1 patients were recommended to have coitus regularly for a week after the HCG treatment. In group 2, IUI was performed 36 h after the HCG treatment.

Results: Clinical pregnancy was provided in 28 patients in 100 patients. In group 1, the pregnancy rate per person was 6%, the pregnancy rate per cycle was 2.3%, and live birth rate was 6%. In group 2, the pregnancy rate per person was 22%, the pregnancy rate per cycle was 8.3%, and live birth rate was 23%. A statistically significant difference was observed between groups 1 and 2 in terms of pregnancy per person rate, pregnancy per cycle rate, and live birth rate.

Conclusion: In the patients who had OI via CC, the pregnancy rates obtained with IUI were statistically significantly higher than timed intercourse.

Keywords: Clomiphene citrate, intrauterine insemination, ovulation induction