Intrauterine insemination for treatment of male infertility

Intrauterine inseminations (IUI) have been performed since the beginning of this century for treatment of infertility. Despite its widespread use the clinical value of this technique remains unclear. Today, indications for IUI include male factor, cervical factor, immunological and unexplained infertility and infertility due to ejaculatory disorders. IUI is superior to intravaginal (IVI) or intracervical insemination (ICI). Before insemination, semen has to be processed using one of the established sperm preparation techniques. Different techniques seem to be equally effective in preparing a highly concentrated sperm fraction with progressively motile, morphologically normal sperm. Ovarian stimulation further improves pregnancy rates achieved by insemination. Human menopausal gonadotropin (HMG) stimulation seems to be superior to clomiphene citrate stimulation. Among other factors, timing and number of inseminations are crucial when influencing the outcome of IUI treatment.