A prospective randomized trial of artificial insemination versus intercourse in cycles stimulated with human menopausal gonadotropin or clomiphene citrate

Per‐Olof Karlström, Karlström PO, P O Karlström, Bergh T, T Bergh, Torbjörn Bergh, Lundkvist O, Örjan Lundkvist, O Lundkvist
Fertility and Sterility · 1993 · vol. 59(3) , pp. 554–559 · doi:10.1016/s0015-0282(16)55799-9 · PMID:8458457 · W145579621
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This prospective randomized trial compared artificial insemination with intercourse in cycles stimulated by human menopausal gonadotropin or clomiphene citrate.

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Abstract

ObjectiveTo determine the relative efficacy of intrauterine insemination (IUI), direct intraperitoneal insemination, and intercourse in cycles stimulated with clomiphene citrate (CC) or human menopausal gonadotropins (hMG).DesignA prospective randomized trial with a 2(3) factorial design with eight different treatment alternatives. Only one cycle per couple was performed.SettingsThe Departments of Obstetrics and Gynecology, Central Hospital, Västerås and Akademiska Hospital, Uppsala University, Uppsala, Sweden.PatientsOf 157 randomized couples with unexplained infertility including 51 cases with minimal or mild endometriosis, 148 were selected for comparison.Main outcome measurePregnancy rate (PR).ResultsFollicular stimulation with hMG gave a higher PR than with CC in the insemination cycles, 19% (10/52) and 4% (2/49), respectively, but the PRs in intercourse cycles were not significantly different for hMG and CC, 13% (3/24) and 17% (4/23), respectively. Insemination cycles and intercourse cycles had a similar overall PR, 12% (12/101) and 13% (7/47), respectively. Furthermore, IUI and direct intraperitoneal insemination did not differ in efficacy.ConclusionFollicular stimulation with hMG is more effective than CC in insemination cycles, but insemination as such seems to have no beneficial effect on the PR in stimulated cycles for treatment of unexplained infertility.

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MeSH descriptors

Clomiphene Coitus Insemination, Artificial Menotropins Menstrual Cycle Adult Clomiphene Clomiphene Female Humans Infertility Infertility Male Menotropins Menstrual Cycle Pregnancy Pregnancy Outcome Prospective Studies

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