IUI
involves a much simpler preparation than IVF to
stimulate multiple ovulations and prepare the sperm.
Furthermore, ovulation is allowed to occur without
an operation to collect the eggs, and the sperm are
injected high into the uterus to reach the eggs in
the fallopian tubes soon after the eggs have been
released. Both superovulation, induced by
gonadotropins, and intrauterine insemination (IUI)
are frequent treatments for infertility.
A
large-scale randomized trial compared the efficacy
of these methods in 932 couples in which the sperm
were motile and the woman had no apparent
infertility factor. Randomization resulted in 231
couples receiving both superovulation and IUI, 234
receiving IUI alone, 234 receiving superovulation
and intracervical insemination, and 233 receiving
intracervical insemination (control subjects).
Superovulation involved a standard protocol of FSH
and human chorionic gonadotropin. Live-born infants
were more common in both superovulation groups than
when only intracervical insemination was performed.
Superovulation and IUI is often recommended as
treatment to infertile couples at our Center;
however we try to temper their expectations of
success. A 3-4-fold increase in pregnancy rates
among couples who had superovulation and IUI
compared with the control group (intracervical
insemination without superovulation) was a success
rate of greater magnitude than we formerly would
have predicted. Our enthusiasm for the combined
procedure was increased after the report of a
randomized study in which superovulation and IUI was
compared with no treatment in women with minimal or
mild endometriosis.
