A 3 year retrospective review of intrauterine insemination, using cryopreserved donor spermatozoa and cycle monitoring by urinary or serum luteinizing hormone measurements

Insemination with donor spermatozoa is an integral part of infertilitytreatment. For the last 3 years in our unit, intrauterine insemination withdonor spermatozoa (IUID) has been used in preference to vaginalinsemination. In this retrospective study, patients were offered an initialcourse of five single intrauterine inseminations with cryopreserved donorspermatozoa and treatment was then reviewed. A total of 389 patientsreceived 1465 inseminations. In all, 1119 cycles were monitored usingluteinizing hormone serum analyses and 346 cycles using the urine home testkits. The clinical pregnancy rate per insemination for the cycles monitoredby the serum assay was 18.0% (202/1119) compared with the urine cycles(13.7%, 46/346) (P <05). The pregnancy loss rate was not significantlydifferent (14.4%, 29/202 and 21.7%, 10/46) (serum and urine cyclesrespectively). The viable clinical pregnancy rate was significantly higher(P <03) for the serum cycles than for the cycles using the urinarymonitoring (15.5%, 173/1119 and 10.4%, 36/346 respectively). The cyclesmonitored by serum assay had a significantly higher cumulative viableclinical pregnancy rate (P <0001) of 70.2% after nine inseminationscompared with the urine monitored cycles of 54.8%. The majority of patientsopted for the serum cycles, with a minority self-selecting the urine cyclesmainly for travelling convenience. The explanation for the significantdifferences between the viable clinical pregnancy rates per inseminationand the cumulative viable clinical pregnancy rates may be due to thesensitivity of the urine home test kit or the patients' interpretation ofthe result.