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Updated: Jul 27, 2025

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Intrauterine Insemination After Human Chorionic Gonadotropin Trigger or Luteinizing Hormone Surge: A Meta-analysis.

Nivedita R Potapragada¹, Elnur Babayev, Danielle Strom

¹Department of Obstetrics and Gynecology, Galter Health Sciences Library, and Department of Preventive Medicine, Biostatistics Collaboration Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Obstetrics and Gynecology

|June 8, 2023

Summary

This meta-analysis found no significant difference in pregnancy rates between using human chorionic gonadotropin (hCG) and luteinizing hormone (LH) monitoring for timing intrauterine insemination (IUI). Both methods offer comparable outcomes for women undergoing IUI.

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Area of Science:

Reproductive Endocrinology
Infertility Treatments
Clinical Trials & Meta-Analyses

Background:

Intrauterine insemination (IUI) is a common infertility treatment.
Optimal timing of IUI is crucial for maximizing pregnancy success.
Current methods for timing IUI include ultrasound monitoring with human chorionic gonadotropin (hCG) administration and luteinizing hormone (LH) level monitoring.

Approach:

A comprehensive systematic literature search was conducted across major databases (PubMed, EMBASE, Scopus, Web of Science, ClinicalTrials.gov, Cochrane Library) up to October 2022.
Thirteen studies, including randomized controlled trials and cohort studies, involving women undergoing IUI with natural cycles or oral medication stimulation were included.
A random-effects model meta-analysis was performed to compare pregnancy outcomes between hCG administration and LH monitoring.

Key Points:

The meta-analysis revealed no statistically significant difference in the odds of pregnancy between IUI timed with hCG administration and LH monitoring (OR 0.92, 95% CI 0.69-1.22, P =.53).
Subgroup analyses for natural cycle IUI and IUI with oral medication stimulation also showed no significant difference in pregnancy rates between the two timing methods.
Significant heterogeneity was noted across the included studies, suggesting potential variations in study populations or methodologies.

Conclusions:

The findings indicate that both ultrasound-guided hCG administration and LH monitoring are equally effective for timing IUI in terms of pregnancy outcomes.
This suggests flexibility in clinical practice regarding IUI timing strategies.
Further research may be warranted to explore factors contributing to the observed heterogeneity.