Techniques used for IUI: is it time for a change?

Abstract

N/A.

Optimization of laboratory procedures for intrauterine insemination: survey of methods in relation to clinical outcome

“…A guideline combining both laboratory and clinical procedures could be the solution to overcome these problems. A first effort was made by reviewing the essential steps for the laboratory stage of IUI, including the pre‐ and post‐laboratory processes (Lemmens et al ., ), thereby overlapping parts of the clinical process.…”

“…The independent variables were semen collection place (at home or both in the clinic or at home), semen preparation technique (density gradient centrifugation, washing, swim‐up, or swim‐down), washing medium (HEPES or bicarbonate), temperature during storage (room temperature, body temperature, or no storage), method of timing IUI (hCG administration, LH surge, ultrasound, or a combination of these), and bed rest after insemination (direct mobilization or bed rest). The selection of independent variables was based on our literature review study (Lemmens et al ., ). First, univariable logistic regression models were fitted.…”

“…The questionnaire was developed based on previous survey studies (Helmerhorst et al ., ; Ombelet et al ., ; Souter et al ., ; Keel et al ., ; Riddell et al ., ), our literature study (Lemmens et al ., ), and input of an expert panel. The questionnaire consisted of 46 questions.…”

“…A same type of laboratory practice variation might be the origin of different pregnancy results after IUI. Despite the fact that there is a recommendation for both SA and sperm preparation for IUI (WHO ), a recent literature review showed that the recommended methods for sperm preparation are characterized by a low level of evidence, insufficient literature, and controversial results (Lemmens et al ., ). On the other hand, from this literature review, some tentative conclusions could be made for an optimal procedure.…”

“…As in the clinical part of IUI, where optimal guideline adherence was reported to have important economical benefits (Haagen et al ., ), this interlaboratory variation is undesirable. On the other hand, coupling this variation in laboratory methods to IUI pregnancy rates may provide more evidence with respect to the optimum procedure as extracted from the literature (Lemmens et al ., ).…”