Evaluation of intrauterine insemination practices: a 1-year prospective study in seven French assisted reproduction technology centers

Abstract

Objective: To determine the best practices of intrauterine insemination with the partner's fresh sperm.

Design: Prospective multicenter observational study.

Setting: Assisted reproduction technology (ART) centers.

Patient(s): Seven hundred and seven patients entering the program, regardless of age or cause of infertility.

Intervention(s): Intrauterine insemination by standard procedures.

Main outcome measure(s): Effect of patient characteristics (duration of infertility, indications, age, parity, body mass index, semen parameters) as well as IUI parameters on delivery rates per couple or per attempt.

Result(s): The overall live birth rate was 11.4% per cycle, varying from 8.4% to 17.6% between centers. The main differences in practice that had a statistically significant impact on the delivery rate were the use of gonadotropin-releasing hormone (GnRH) antagonists (15.2% with versus 9.4% without) and the number of mature recruited follicles (9.4% for one versus 15.2% for two).

Conclusion(s): Our results indicate that the use of GnRH antagonists has a positive effect on the delivery rate, especially in the multifollicular stimulations that are required when women are older than 27 years.

Keywords: Delivery; GnRH antagonist; IUI; ovarian stimulation.