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

Abstract

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.

The effect of unilateral tubal block diagnosed by hysterosalpingogram on clinical pregnancy rate in intrauterine insemination cycles: systematic review and meta‐analysis

“…These surgical options can be an alternative or predecessor to IVF, and are potential options for younger women . Conversely, IVF/ICSI may be a more suitable option in cases of concurrent male factor infertility, advanced maternal age, low ovarian reserve, or extensive disease not amenable to surgery …”

The impact of hyperandrogenism on the outcomes of ovulation induction using gonadotropin and intrauterine insemination in women with polycystic ovary syndrome

“…The most common drug of choice is clomiphene citrate and gonadotropin, while letrozole and metformin may also be used off-label [ 6 ]. OI with intrauterine insemination (IUI; OI+IUI) is the option of choice when there is coexisting suboptimal semen quality [ 7 ]. Although the effectiveness is unclear, performing IUI in ovulation-induced cycles is widely used for women with PCOS without male-related factors [ 8 ].…”

Controlled ovarian stimulation should not be preferred for male infertility treated with intrauterine insemination: a retrospective study

“…Intrauterine insemination (IUI) is an effective and frequently used fertility treatment for couples with male factor and unexplained infertility since it is less invasive, less stressful, more easily accepted by patients, and more cost-effective [4][5][6][7][8][9]. In IUI, a small volume of prepared semen, removing content which might interfere with fertilisation, such as dead and immotile spermatozoa, debris, white cells, and seminal plasma, is injected directly into the uterine cavity around the expected time of ovulation.…”