BACKGROUND<\/p>\n
The rationale for double insemination is to create the opportunity for a longer fertilization period as follicle rupture may occur over a wide interval (~22–47 h) after hCG administration in ovarian hyperstimulation (OH) with intrauterine insemination (IUI) cycles. This randomized study evaluates the effectiveness of single versus double IUI in only OH cycles with multi-follicular development.<\/p>\n
METHODS<\/p>\n
We conducted a single center trial, 228 eligible patients were randomized for this study on the day of hCG. Only cycles with multi-follicular development without premature luteinization (progesterone levels >1 ng\/ml on the day of hCG), were included in the study. Multi-follicular development has been defined as at least two dominant follicles reaching minimum ≥15 mm diameter in which one of them is >17 mm. OH cycles with more than five dominant follicles (>15 mm in diameter) were excluded from the study. In the single IUI group (Group 1 = 112 patients) IUI was applied 36 h after the hCG injection and in the double IUI group (Group 2 = 114 patients) the first IUI was performed 18 h after hCG administration and the second IUI was performed 40 h after hCG administration. The primary end-point is to compare live birth rates (LBRs) between single and double IUI arms.<\/p>\n
RESULTS<\/p>\n
LBRs were 10.7% (12\/112 patients) in the single IUI group and 12.3% (14\/114) in the double IUI group and the difference was not statistically significant (P<\/I> = 0.835, OR = 1.16, 95% CI: 0.51–2.64). In the unexplained infertility group the LBR was 11.1% (5\/45 patients) with single IUI and 18.4% (9\/49) with double IUI (P<\/I> = 0.393). In the mild male factor group this rate was 10.4% (7\/67) and 7.7% (5\/65) in the single and double IUI groups, respectively (P<\/I> = 0.764).<\/p>\n
CONCLUSION<\/p>\n
Our study did not find any difference in LBRs between single and double IUI groups in OH cycles with multi-follicular development. To the best of our knowledge this is the first report with this kind of study design.<\/p>\n
The study was registered at clinicaltrials.gov: NCT 00993902.<\/p>\n","protected":false},"excerpt":{"rendered":"
BACKGROUND The rationale for double insemination is to create the opportunity for a longer fertilization period as follicle rupture may occur over a wide interval (~22–47 h) after hCG administration in ovarian hyperstimulation (OH) with intrauterine insemination (IUI) cycles. This … Continue reading