[Homologous intrauterine insemination as a therapeutic possibility in andrologically-induced sterility]

In a two-years period, we treated 58 infertile couples for a total of 213 cycles with artificial homologous insemination (AIH). We considered a indication for AIH low sperm quality or a pathological postcoital test (PCT). Couples with idiopathic infertility did not receive AIH. If possible, AIH was performed by intrauterine insemination (IUI), following concentration of the motile sperms by "swim-up" method. Out of 213 cycles "swim-up", preparation could not be done in 46 cases (21.6%) because the initial sperm quality was below technical limits (sperm count below 1 Mio/ml). Out of 58 treated couples 4 became pregnant during AIH therapy (7%) among, them 2 couples conceiving twice after spontaneous early abortion. The total pregnancy rate per cycle was 2.8%. In the cycles after "swim-up", the monthly pregnancy rate through IUI was 3.6%. In the presence of andrological factors was the pregnancy rate only 0.9% compared to 6.8% in cases of pathological PCT with normal sperm quality. Thus, it can be concluded, that IUI is not successful on the basis of low sperm quality. Only in cases of unfavourable cervical factor expressed by a pathological PCT accompanied with a normal spermiogramm, moderate success can be expected.