A randomized controlled trial comparing the effectiveness of single versus double intrauterine insemination in unexplained infertility

Rahman, Syed Monajatur; Malhotra, Neena; Kumar, Sunesh; Roy, Kallol Kumar; Agarwal, Ashok

doi:10.1016/j.fertnstert.2010.06.082

Cited by 15 publications

(4 citation statements)

References 16 publications

(15 reference statements)

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“…Recent studies have shown no significant differences between the protocols. [67][68][69] Insemination at 36 hours after hCG administration has been the preferred time for IUI, but no difference in pregnancy rates was observed when compared with double 12-and 36-hour inseminations. 70 A recent metaanalysis reported that double IUI offered no clear benefits to the overall clinical pregnancy rates in couples with unexplained infertility.…”

Section: Which Methods Is Better?mentioning

confidence: 99%

Indications of Intrauterine Insemination for Male and Non–Male Factor Infertility

Kim

Park

2014

Semin Reprod Med

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Intrauterine insemination (IUI) is a widely used fertility treatment for couples with male and/or non-male factor infertility and is a relatively simple and inexpensive procedure. When used for unexplained infertility, IUI combined with ovarian stimulation increases the pregnancy rates, but evidence does not support this to be true when applied for male factor infertility. Recently, the revised World Health Organization laboratory manual for semen criteria provided a new insight for practical guidelines. Further randomized, controlled studies are necessary to develop standardized IUI strategies. The authors reviewed, via literature search, on the indications, prognostic factors, ovarian stimulation protocols, and methods that have been employed for IUI treatment.

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Section: Which Methods Is Better?mentioning

confidence: 99%

Indications of Intrauterine Insemination for Male and Non–Male Factor Infertility

Kim

Park

2014

Semin Reprod Med

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“…Of the remaining 375 papers, 117 did not classify a definition of unexplained infertility. As a result, a total of 258 primary research papers with full text available were included …”

Section: Resultsmentioning

confidence: 99%

The definition of unexplained infertility: A systematic review

Raperport,

Desai,

Qureshi

et al. 2023

BJOG

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BackgroundThere is no consensus on tests required to either diagnose unexplained infertility or use for research inclusion criteria. This leads to heterogeneity and bias affecting meta‐analysis and best practice advice.ObjectivesThis systematic review analyses the variability of inclusion criteria applied to couples with unexplained infertility. We propose standardised criteria for use both in future research studies and clinical diagnosis.Search strategyCINAHL and MEDLINE online databases were searched up to November 2022 for all published studies recruiting couples with unexplained infertility, available in full text in the English language.Data collection and analysisData were collected in an Excel spreadsheet. Results were analysed per category and methodology or reference range.Main resultsOf 375 relevant studies, only 258 defined their inclusion criteria. The most commonly applied inclusion criteria were semen analysis, tubal patency and assessment of ovulation in 220 (85%), 232 (90%), 205 (79.5%) respectively. Only 87/220 (39.5%) studies reporting semen analysis used the World Health Organization (WHO) limits. Tubal patency was accepted if bilateral in 145/232 (62.5%) and if unilateral in 24/232 (10.3%). Ovulation was assessed using mid‐luteal serum progesterone in 115/205 (56.1%) and by a history of regular cycles in 87/205 (42.4%). Other criteria, including uterine cavity assessment and hormone profile, were applied in less than 50% of included studies.ConclusionsThis review highlights the heterogeneity among studied populations with unexplained infertility. Development and application of internationally accepted criteria will improve the quality of research and future clinical care.

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“…In the same study, the sperm density, and cycle numbers have been found to influence pregnancy outcome too but the insemination timing, and frequency have been found to exert little effect (Xu et al 2013 ). In a prospective randomized trial, Rahman et al ( 2010 ) have evaluated the clinical efficacy of double IUI over single IUI and no benefit of double IUI has been detected among unexplained infertile patients. Although the best application time and frequency for IUI procedures have not been detected, longer survival period of spermatozoa within the female genital tract, unlike oocyte, result with broader time interval preferences for successful IUI procedures.…”

Section: Discussionmentioning

confidence: 99%

Which is the best intrauterine insemination timing choice following exogenous hCG administration during ovulation induction by using clomiphene citrate treatment? A retrospective study

et al. 2016

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ObjectiveTo evaluate the impact of intrauterine insemination timing performed 24 or 36 h later following ovulation trigger on clinical pregnancy rate during ovulation induction with clomiphene citrate among infertile women was the objective of this study.MethodsThe medical records of 280 infertile patients who have underwent ovulation induction by using clomiphene citrate have been evaluated and cycle outcomes of the patients have been investigated specifically based on the timing of intrauterine insemination during the treatment cycle.ResultsThe clinical pregnancy rate of the study group based on the timing of intrauterine insemination (24 vs. 36 h following hCG trigger) was found to be similar regardless of infertility type. The cycle day of which hCG trigger has been performed was found to be significantly longer for patients who have achieved clinical pregnancy than patients who have not got pregnant following the treatment cycle. Dominant follicle diameter has not been found to affect clinical pregnancy rate during treatment cycles with clomiphene citrate.ConclusionsIn this study, intrauterine insemination timing did not affect the cycle outcomes whether the procedure has been performed 24 or 36 h later following ovulation trigger with exogenous hCG utilization. The longer period of treatment cycle during ovulation induction with clomiphene citrate resulted with higher clinical pregnancy rate. Intrauterine insemination can be done successfully at either 24 or 36 h after hCG in clomiphene citrate stimulated cycles. This will allow more flexibility and convenience for both physicians and patients, especially during weekends.

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A randomized controlled trial comparing the effectiveness of single versus double intrauterine insemination in unexplained infertility

Cited by 15 publications

References 16 publications

Indications of Intrauterine Insemination for Male and Non–Male Factor Infertility

Indications of Intrauterine Insemination for Male and Non–Male Factor Infertility

The definition of unexplained infertility: A systematic review

Which is the best intrauterine insemination timing choice following exogenous hCG administration during ovulation induction by using clomiphene citrate treatment? A retrospective study

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