The pregnancy outcomes of intrauterine insemination with husband's sperm in natural cycles versus ovulation stimulated cycles: A retrospective study

Ye F, Feijun Ye, Cao W, Wenli Cao, Lin J, Jing Lin, Yan Du, Lan L, Likun Lan, Dong Y, Ying Dong, Zhu J, Jun Zhu, Zhou Q, Qi Zhou, Pan X, Xinyao Pan, Youhui Lu, Lu Y, Fang Zeng, Zeng F, Xia B, Bangshi Xia, Ling Wang
Bioscience trends · 2018 · doi:10.5582/bst.2018.01164 · PMID:30473553
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

Intrauterine insemination with ovulation stimulation did not improve pregnancy rates compared to natural cycles, except for women over 35 and those with ovulation disorders or unexplained infertility.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This retrospective study compared clinical pregnancy outcomes of intrauterine insemination using husbands’ sperm in 991 IUI cycles performed at Zhoushan Maternity and Child Healthcare Hospital from 2008–2017, including 455 natural cycles and 536 ovulation-stimulated cycles. Overall clinical pregnancy rates were not significantly different between natural and stimulated cycles, and medication-stratified results across clomiphene, HMG, and FSH (including combinations) also did not show significant differences versus natural cycles. When stratified by infertility etiology, stimulated cycles had higher pregnancy rates for ovulation disorders and unexplained factors but lower rates for cervical factors, endometriosis, male factor, and other female factors; women over 35 showed a higher pregnancy rate with stimulation, whereas women under 35 did not. A key limitation is the retrospective design, which cannot control for confounding despite subgroup stratification. Relevance to endometriosis: endometriosis was explicitly included as an infertility etiology in subgroup analyses where pregnancy rates were significantly lower in stimulated cycles versus natural cycles, though the paper’s main focus is comparative IUI outcomes in natural versus ovulation-stimulated cycles.

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Abstract

To compare the clinical outcomes of intrauterine insemination (IUI) with or without ovulation induction (OI), IUI cycles from January 2008 to December 2017 in Zhoushan Maternity and Child Healthcare Hospital were included, consisting of 455 natural cycles and 536 OI cycles. The overall clinical pregnancy rate did not differ between the two groups (P > 0.05). Stratified by OI medications such as clomiphene (CC), human menopausal gonadotropin (HMG) and follicle stimulating hormone (FSH), the pregnancy rates in HMG, CC, CC+HMG, and FSH/FSH+HMG groups were 11.70%, 13.58%, 15.95%, and 13.46%, respectively, but the difference was not significant compared with natural cycles (P > 0.05). Stratified by infertility etiology, the pregnancy rate was significantly higher in stimulated cycles than natural cycles with ovulation disorders (P < 0.01) and unexplained factors (P < 0.01) while it was significantly lower regarding cervical factors (P < 0.01), endometriosis (P < 0.05), male factor (P 0.05). Stratified by age category, women over 35 had higher pregnancy rate in stimulated cycles compared with natural cycles (18.75 vs. 12.24%; P 0.05). However, there was no significant difference between each ovarian stimulation group and natural cycle group regardless of the infertility causes or age categories. To conclude, IUI-OI could achieve a higher overall pregnancy rate for women over 35 and infertile patients with ovulation disorders and unexplained factors.
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Keywords

Intrauterine insemination (IUI), ovulation induction (OI), stimulated cycles, natural cycles, clinical pregnancy rate 2018 Volume 12 Issue 5 Pages 463-469 Details

Abstract

To compare the clinical outcomes of intrauterine insemination (IUI) with or without ovulation induction (OI), IUI cycles from January 2008 to December 2017 in Zhoushan Maternity and Child Healthcare Hospital were included, consisting of 455 natural cycles and 536 OI cycles. The overall clinical pregnancy rate did not differ between the two groups (P > 0.05). Stratified by OI medications such as clomiphene (CC), human menopausal gonadotropin (HMG) and follicle stimulating hormone (FSH), the pregnancy rates in HMG, CC, CC+HMG, and FSH/FSH+HMG groups were 11.70%, 13.58%, 15.95%, and 13.46%, respectively, but the difference was not significant compared with natural cycles (P > 0.05). Stratified by infertility etiology, the pregnancy rate was significantly higher in stimulated cycles than natural cycles with ovulation disorders (P < 0.01) and unexplained factors (P < 0.01) while it was significantly lower regarding cervical factors (P < 0.01), endometriosis (P < 0.05), male factor (P 0.05). Stratified by age category, women over 35 had higher pregnancy rate in stimulated cycles compared with natural cycles (18.75 vs. 12.24%; P 0.05). However, there was no significant difference between each ovarian stimulation group and natural cycle group regardless of the infertility causes or age categories. To conclude, IUI-OI could achieve a higher overall pregnancy rate for women over 35 and infertile patients with ovulation disorders and unexplained factors. © 2018 International Research and Cooperation Association for Bio & Socio-Sciences Advancement Favorites & Alerts Recently viewed articles

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Condition tags

endometriosisinfertility

MeSH descriptors

Insemination, Artificial Ovulation Induction Spermatozoa Adult China Clomiphene Clomiphene Corpus Luteum Corpus Luteum Female Follicle Stimulating Hormone Follicle Stimulating Hormone Follow-Up Studies Humans Infertility Infertility Insemination, Artificial Male Ovulation Ovulation Induction

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