We scored an average clinical pregnancy rate of 34.6% per couple in a study the study Intrauterine Insemination In 1,131 Cycles, published in Acta Obstetricia et Gynecologica Scandinavica (2001; 80: 342-348). Only cryogenically preserved donor sperm from our headquarters in Denmark was used throughout the eight-year period of the study.

Abstract

Objective: To identify prognostic factors influencing the outcome of infertility treatment using intrauterine insemination with donor semen (IUI-D).
Design: Retrospective study of all patients undergoing IUI-D between August 1st, 1990 and July 31st, 1998.
Setting: University-affiliated infertility clinic.
Patients: Three hundred five couples undergoing 1131 IUI-D treatment cycles.
Main outcome measures: Type of hormonal treatment, number of follicles, length of follicular phase, endometrial pattern, female age, infertility diagnosis and semen quality related to clinical pregnancy rate, cumulative birth rate and multiple gestations.
Results: Throughout the nine year period the overall clinical pregnancy rate per cycle was 22.3% with an increase from 12.9% in 1990 to 34.6% in 1998. The multiple birth rate was 20.6%. The birth rate per couple was 61.1% after a mean of 3.2 treatment cycles. The pregnancy rate was highest in the first treatment cycle and the cumulative birth rate rose only slightly after the sixth treatment cycle.

Parameters

The following parameters were positively and significantly correlated to a successful outcome of IUI-D:
i) the first treatment cycle – compared to the following up to six treatment cycles;
ii) number of mature follicles – more than one - at the time of insemination, however, with an unacceptable high rate of multiple pregnancies with more than 3 mature follicles;
iii) time of insemination after the 12th day in the cycle;
iv) insemination after ovulation and;
v) female age under 30 years.

Conclusions

IUI-D is a simple and inexpensive treatment giving acceptable pregnancy rates for up to six treatment cycles if at least 2 mature follicles have developed at the time of insemination, which implies that hormonal ovarian stimulation and induction of ovulation is used, and ovulation has occurred at the time of insemination, which ought to take place after cd 12 with at least one million motile spermatozoa.