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Comparison of intracervical, intrauterine, and intratubal techniques for donor insemination
W W Hurd1, J F Randolph, R Ansbacher
1Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor 48109-0718.
Objective:
To compare the efficacy of intracervical insemination (ICI), intrauterine insemination (IUI), and a combination of intratubal and intrauterine insemination (ITI/IUI) for donor insemination.
Design:
Prospective randomized clinical trial.
Setting:
The University of Michigan donor insemination program.
Patients, Participants:
Forty-one women undergoing donor insemination with cryopreserved sperm for either isolated male factor or male factor plus ovulatory dysfunction corrected by clomiphene citrate.
Intervention:
Each patient was randomly assigned to receive each of the three insemination techniques in consecutive cycles until pregnancy occurred or the patient dropped from the study.
Main Outcome Measures:
Cycle fecundity rates were compared using the chi 2 test, and cumulative pregnancy rates (PRs) determined by life table analysis were compared using a log-rank test.
Results:
Cycle fecundity rate was significantly higher for IUI (18.3%) than for ICI (3.9%) or ITI/IUI (7.3%). By life table analysis, the cumulative PR for IUI was significantly higher than for ICI, but the PR for ITI/IUI was not.
Conclusion:
For donor insemination with cryopreserved sperm, IUI increases cycle fecundity compared with ICI. The addition of ITI to IUI, however, interferes with the apparent beneficial effect of IUI alone.