Intrauterine insemination of washed spermatozoa for treatment of oligozoospermia

Abstract

Efficacy of intrauterine insemination (IUI) using washed spermatozoa for treatment of oligozoospermia was evaluated by a prospective randomized study in 50 couples, using LH-timed natural intercourse in the alternate menstrual cycles as a control. The quality of spermatozoa in terms of their concentration and motility before and after sperm washing was compared. Sperm motility increased significantly after sperm preparation but the number of sperm was reduced. Eight pregnancies occurred in 253 cycles of IUI with washed spermatozoa and clomiphene citrate-stimulated cycles (3.16% per cycle). Only one patient conceived in 242 LH-timed natural intercourse cycles (0.41% per cycle). Compared with LH-timed natural intercourse, IUI provided a significantly improved pregnancy rate. When the sperm count was < 5 x 10(6) per ml, no pregnancy occurred with the IUI method. Therefore, IUI is a of rather limited usefulness when the sperm quality is very poor. Few complications occurred after IUI, but included slight cervical contact bleeding and mild abdominal discomfort and/or cramps. In conclusion, IUI should be considered as a useful and relatively non-invasive therapeutic modality for treating caused by moderate oligozoospermia (> 5 x 10(6)/ml), when sexual intercourse fails.

Case series of a single centre's treatment of ovulatory infertility with clomiphene citrate and intrauterine insemination in 2002

“…Likewise, the CPR was significantly improved with CC and IUI compared to NC and TI in 40 women with unexplained, male or cervical infertility undergoing a maximum of four treatment cycles (14.3 vs 0%; P = 0.03) 12 . Aribarg and Sukcharoen also demonstrated a higher CPR with CC and IUI compared to NC and TI in 50 couples with male factor infertility having up to four to six treatment cycles (3.2 vs 0.4%; P = 0.02) 13 . Periovulatory hCG trigger was administered only in the CC and IUI cycles in the first trial, whereas no hCG trigger was given in the latter two trials.…”

“…The best way to evaluate whether CC and IUI treatment in couples with ovulatory infertility improves the probability of conception compared to the natural chance of conceiving would be to perform a randomised controlled trial (RCT) comparing CC and IUI with timed intercourse (TI) in the natural cycle (NC) (NC and TI). There have been three such RCT published and all demonstrated a significant improvement in CPR with CC and IUI 11–13 . In addition, a meta‐analysis of these three trials, published in the same issue of this journal 14 demonstrated a 4.6‐fold significantly higher CPR with CC and IUI compared to TI in the NC in couples with ovulatory infertility.…”

Systematic review of the treatment of ovulatory infertility with clomiphene citrate and intrauterine insemination

“…A total of seven RCT that met the inclusion criteria were identified and thus consulted in the review 9–15 . All seven studies were considered to be of a reasonable methodological standard to be included in the review.…”

“…Four of the seven RCT were of cross‐over design, 9–12 with the other three being parallel group studies 13–15 . None of the trials were blinded.…”

Sperm Preparation Techniques for Artificial Insemination - Comparison of Sperm Washing, Swim Up, and Density Gradient Centrifugation Methods

“…With the exception of cases in which the use of in vitro fertilization (IVF or ICSI) is strictly due as a consequence of a severe male or female factor, the artificial insemination must be part of a gradual approach to the techniques of artificial insemination. This is particularly the case since the AI is a valid low-cost method, minimally invasive and easily acceptable for the female's hormone treatment (Aribarg & Sukcharoen, 1995). The AI, as other assisted reproductive techniques, needs a selection of the ejaculated spermatozoa before the performance of the treatment.…”