The treatment of infertility by the high intrauterine insemination of husband's washed spermatozoa

A total of 345 couples with non-tubal infertility on an IVF waiting list underwent 702 treatment cycles involving daily intrauterine inseminations of husband's washed spermatozoa (AIH) over 3 days of the periovulatory period, following ovarian stimulation. Pregnancy rates achieved were dependent upon the underlying infertility disorder, with similar rates noted in those with a negative post-coital test (15.8%) or where antispermatozoal antibodies were present in either the male (18.5%) or female (17.1%) partner. These rates were significantly higher than for couples with poor cervical mucus (4.7%), asthenozoospermia (0%), endometriosis (mild, 7.7%; severe, 4.1%) or unexplained infertility (8.5%), while discrete oligozoospermia showed mid-range results (10.3%). Pregnancy outcome revealed a high level of early wastage (33.3%), mainly in the blighted ovum category, however congenital abnormalities (5.6%) were not significantly increased. It is concluded that the procedure of AIH should be considered for infertility due to poor sperm--mucus interaction, antispermatozoal antibodies and simple oligozoospermia, prior to IVF-related treatments.