Infertility: Intra-uterine insemination or timed intercourse after ovarian stimulation for male subfertility? A controlled study

In this randomized trial we investigated whether intra-uterineinsemination (IUI) in couples with male subfertility leads toa higher probability of conception than timed intercourse afterovarian stimulation with human menopausal gonadotrophin (HMG)and human chorionic gonadotrophin (HCG). A total of 76 couplesstarted 249 cycles, of which 47 were cancelled to prevent multiplepregnancies or hyperstimulation. After 202 completed treatmentcycles, 15 pregnancies occurred, 11 after IUI and four aftertimed intercourse. The pregnancy rate per completed cycle withIUI was 10.3% (95% confidence interval: 5.5–17.5%) and4.2% (1.2–10.1%) with timed intercourse. Compared withthe estimated spontaneous chance to conceive, IUI after ovarianstimulation appeared to be more effective in the first threecycles. We conclude that in subfertile couples with a male factor,IUI tends to improve the probability of conception as comparedto timed intercourse when ovarian stimulation is applied, andwe advise such treatment for three cycles.