Single versus double insemination: a retrospective audit of pregnancy rates with two treatment protocols in donor insemination

Our objective was to evaluate the effect of a change in treatmentprotocols, suggested following an inspection visit by the regulatoryauthority, from single to double inseminations during donor inseminationtreatment cycles. We therefore conducted a retrospective audit of pregnancyrates in the reproductive medicine clinic of a major teaching hospital. Allpatients were treated for male factor infertility by donor insemination,without ovulation induction with gonadotrophins between October 1992 andDecember 1995. The main outcome measures were cumulative conception andlive birth rates. During the study period 250 patients underwent treatmentand 650 single insemination and 277 double insemination treatment cycleswere undertaken. The pregnancy rate per cycle was 0.054 and 0.119 forsingle and double insemination respectively. After six cycles thecumulative pregnancy rates were 0.28 and 0.47 and the take-home baby rateswere 0.25 and 0.37 for single and double inseminations respectively. Thechange in practice from single to double insemination resulted in adoubling of the pregnancy rate per treatment cycle. Cumulative pregnancyrates after two treatment cycles of double insemination were comparablewith those achieved after six cycles of single insemination. These resultshave significant implications for both patients and purchasers.