Double intrauterine insemination (IUI) of no benefit over single IUI among lesbian and single women seeking to conceive

Monseur, Brent; Franasiak, Jason M.; Sun, Li; Scott, Richard T.; Kaser, Daniel J.

doi:10.1007/s10815-019-01561-3

Cited by 8 publications

(7 citation statements)

References 25 publications

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“…[36][37][38] A recent study that found that double intrauterine insemination with donor sperm did not increase ongoing pregnancy rates in women without a history of infertility provides additional evidence supporting that increasing frequency matters to cover the fertile window, but does not improve pregnancy rates once the fertile window is already attained. 39 Our simulation supports the principle that unscheduled regular intercourse, averaging every other day, will greatly increase the chances of intercourse occurring within the fertile window, which will, in turn, improve time to pregnancy. However, for a variety of personal reasons, some couples of normal fecundity 35,37,38 may find timing of intercourse to the fertile window a more acceptable approach to increase fecundability, for example among women who experience pain with intercourse.…”

Section: Discussionsupporting

confidence: 71%

“…Though the body of existing data on the impact of timed intercourse is insufficient to draw conclusions, 35 recent observational studies and a trial in couples trying to conceive suggest that timing of intercourse to the fertile window using fertility indicators result in higher fecundability independent of coital frequency, further highlighting the importance of intercourse timing 36‐38 . A recent study that found that double intrauterine insemination with donor sperm did not increase ongoing pregnancy rates in women without a history of infertility provides additional evidence supporting that increasing frequency matters to cover the fertile window, but does not improve pregnancy rates once the fertile window is already attained 39 …”

Section: Commentmentioning

confidence: 99%

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Sporadic anovulation is not an important determinant of becoming pregnant and time to pregnancy among eumenorrheic women: A simulation study

DeVilbiss

Stanford

Mumford

et al. 2020

Paediatric Perinatal Epid

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Background Attaining pregnancy is conditional upon a series of complex processes, including adequately timed intercourse, ovulation, fertilisation, and implantation. Anovulation is a first‐line treatment target for couples with difficulty conceiving and is frequently examined in studies of fecundability. Objectives To identify whether sporadic anovulation is an important determinant of cumulative pregnancy rates and time to pregnancy among fertile women with regular menstrual cycles. Methods We simulated cumulative pregnancy rates and time to pregnancy for 12 consecutive menstrual cycles among 100 000 women based on data‐driven probabilities of implantation, fertilisation, ovulation, and intercourse occurring in the fertile window. We assumed anovulation probabilities of 1%, 8%, or 14.5% and intercourse averaging once per week, every other day, or daily. The model incorporated reductions in implantation and fertilisation rates for successive cycles of non‐pregnancy. Results After 12 cycles, a reduction in the per cycle incidence of anovulation from 14.5% to 1% resulted in a 4.0% higher cumulative pregnancy rate (86.7% vs 90.7%) and similar time to pregnancy (1‐cycle median difference). In contrast, increasing mean unscheduled sexual intercourse frequency from weekly to every other day was associated with a 5‐cycle median reduction in time to pregnancy (weekly: 7 cycles; every other day or daily: 2 cycles) and a 28.9% increase in the cumulative pregnancy rate (weekly: 59.9%, every other day: 88.8%; daily: 91.6%). Conclusions In presumed fertile women with regular menstrual cycles, routine investigation of anovulation may not be an informative outcome in studies of fecundability, and routine testing to ensure ovulation and treatment of anovulation are unlikely to be medically necessary. While biomarkers or cervical fluid may help time intercourse to the fertile window, time to pregnancy can also be improved through increasing the frequency of unscheduled intercourse. These findings need corroboration in large preconception time to pregnancy studies.

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Section: Discussionsupporting

confidence: 71%

Section: Commentmentioning

confidence: 99%

Sporadic anovulation is not an important determinant of becoming pregnant and time to pregnancy among eumenorrheic women: A simulation study

DeVilbiss

Stanford

Mumford

et al. 2020

Paediatric Perinatal Epid

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“…Most studies investigating fertility treatment outcomes using donor sperm only focused on IUI treatments. Moreover, they did not compare the results with treatments using partner sperm, which could be considered the standard patient group for which most ART procedures were developed [ 7 , 21 , 22 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Assisted Reproductive Technology Results Using Donor or Partner Sperm: A Danish Nationwide Register-Based Cohort Study

Catalini

Fedder

Nørgård

et al. 2023

JCM

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This was a nationwide cohort study based on Danish health registers focusing on assisted reproductive technology (ART) treatments in women using donor or partner sperm from 2007 to 2017. Women using donor sperm were subdivided into groups based on relationship status: women with male partners, single women, or women with female partners. The live birth adjusted odds ratios (aORs) after the IUI treatments in women using donor sperm compared with women using partner sperm were 1.48 (95% CI: 1.38–1.59) in women with male partners using donor sperm, 1.20 (95% CI: 1.13–1.28) in single women, and 1.46 (95% CI: 1.32–1.62) in women with female partners. The live birth aORs after IVF treatments in women using donor sperm compared with women using partner sperm were 1.16 (95% CI: 1.02–1.32) in women with male partners using donor sperm, 0.88 (95% CI: 0.80–0.96) in single women, and 1.20 (95% CI: 1.00–1.44), in women with female partners. The use of donor sperm was associated with a higher chance of a live birth after the IUI treatments, but there was no difference after the IVF treatments. Our study invites healthcare professionals to increase their attention toward the different needs and fertility issues of all women attending fertility clinics.

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“…In contrast, one study found that access to infertility treatment was increased for LGBTQ + patients through funding from charity foundations [71]. Regarding MAR outcomes, three studies found more positive outcomes for LGBTQ + patients compared to their heterosexual and cisgender counterparts [44,60,66]. Downing et al found no differences in outcome risks between same-sex couples using ART and those not using ART [37].…”

Section: Educationmentioning

confidence: 99%

Inequities in Medically Assisted Reproduction: a Scoping Review

et al. 2023

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Infertility has a high prevalence in the USA and health inequities play a large role in access to medically assisted reproduction (MAR). The aim of this study was to identify gaps in research pertaining to inequities in MAR and propose suggestions for future research directions. Searches were performed using MEDLINE and Ovid Embase. Articles that reported on MAR inequities, published between 2016 and 2021 in the USA, and written in English were included. The inequities investigated were adapted from the NIH-designated health disparities populations. Each article’s inequity findings were extracted and reported, along with frequencies of inequities. Our sample included 66 studies. The majority of the studies investigated MAR outcomes by race/ethnicity and found that historically marginalized populations had poorer outcomes. LGBTQ + populations were less likely to use MAR or seek infertility care. Most studies found positive correlations with MAR use with income and education. The least commonly studied inequities in our sample were sex and/or gender and rural/under-resourced populations; findings showed that men and people from rural/under-resourced populations were less likely to access MAR. Studies that examined occupational status had varying findings. We suggest that future research be targeted toward: (1) standardizing and diversifying race/ethnicity reporting regarding MAR, (2) the use of community-based participatory research to increase data for LGBTQ + patients, and (3) increasing access to infertility care for men. Supplementary Information The online version contains supplementary material available at 10.1007/s43032-023-01236-6.

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Double intrauterine insemination (IUI) of no benefit over single IUI among lesbian and single women seeking to conceive

Cited by 8 publications

References 25 publications

Sporadic anovulation is not an important determinant of becoming pregnant and time to pregnancy among eumenorrheic women: A simulation study

Sporadic anovulation is not an important determinant of becoming pregnant and time to pregnancy among eumenorrheic women: A simulation study

Assisted Reproductive Technology Results Using Donor or Partner Sperm: A Danish Nationwide Register-Based Cohort Study

Inequities in Medically Assisted Reproduction: a Scoping Review

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