Methods to increase the success rate of artificial insemination with donor semen

Donor insemination was performed in two fertility clinics usingcryopreserved semen from the same sperm bank. Donors were selectedin agreement with American Fertility Society recommendations.In the first clinic, cup insemination was combined with intra-uterineinsemination in 321 cycles. Follicular development was closelymonitored with vaginal echography and serum hormonal measurements.In the second clinic, 1287 insemination cycles were performedusing intra-cervical insemination, timed only on basal bodytemperature. In the first clinic, a total of 53 pregnancieswere obtained, of which seven were in 55 unstimulated cycles(12.5%), 21 in 159 cycles with clomiphene citrate stimulation(13.1%, P> 0.1), and 25 in 107 cycles stimulated with clomipheneplus human menopausal gonadotrophin (HMG) (23.9%, P< 0.03).No multiple pregnancies were observed in the latter group. Inthe second clinic, 159 pregnancies occurred during 1287 inseminationcycles (12.4%). It is concluded that neither intra-uterine insemination,nor hormonal and echographic cycle monitoring, nor clomiphenecitrate enhances the success rate of artificial inseminationwith donor semen, but HMG treatment probably exerts a favourableeffect