A comparative study using prepared and unprepared frozen semen for donor insemination

Area of Science:

• Reproductive Medicine
• Infertility Treatments
• Assisted Reproductive Technology

Background:

• Therapeutic donor insemination is a common treatment for infertility.
• The method of semen preparation and insemination technique can impact pregnancy rates.
• Optimizing donor insemination protocols is crucial for improving success rates.

Purpose of the Study:

• To compare the efficacy of pericervical insemination with unprepared donor semen versus intrauterine insemination with prepared donor semen.
• To evaluate pregnancy rates in a prospective, randomized, crossover clinical trial.
• To determine the optimal number of treatment cycles before considering alternative therapies.

Main Methods:

• A prospective, randomized, crossover trial involving 54 patients undergoing therapeutic donor insemination.
• Patients were randomized to receive either intrauterine insemination with prepared donor semen or pericervical insemination with unprepared donor semen in alternating cycles.
• Semen preparation involved double wash and swim-up techniques for intrauterine insemination.

Main Results:

• Intrauterine insemination with prepared semen resulted in a significantly higher pregnancy rate (20.4% per cycle) compared to pericervical insemination with unprepared semen (3.4% per cycle, p = .005).
• Pregnancy rates per cycle were 13.2% (1st cycle), 17.4% (2nd cycle), 13.2% (3rd cycle), 7.1% (4th cycle), and 4.8% (after 4th cycle).
• A decline in pregnancy rates was observed after the fourth treatment cycle.

Conclusions:

• Intrauterine insemination with prepared donor semen is a more effective method for achieving pregnancy in therapeutic donor insemination.
• The study supports the use of prepared semen and intrauterine insemination as a primary treatment strategy.
• Considering alternative therapies after four failed cycles of therapeutic donor insemination is recommended due to decreasing success rates.