Intrauterine Insemination in Women with Endometriosis

In: Endometriosis-related Infertility · 2024 · pp. 163–170 · doi:10.1007/978-3-031-50662-8_13 · W4392309488
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Intrauterine insemination improves fertility in early-stage endometriosis, with controlled ovarian hyperstimulation enhancing pregnancy rates, but may be less effective in advanced stages.

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This chapter reviews evidence on intrauterine insemination (IUI) with or without superovulation for treating endometriosis-related infertility, summarizing studies that vary in sample size and design. It reports that IUI improves fertility compared with expectant management in women with stages I–II endometriosis, and that combining IUI with controlled ovarian hyperstimulation yields higher pregnancy rates than IUI alone in these patients. For stages III–IV endometriosis, IUI appears less efficacious than in earlier stages, potentially due to anatomic distortion, and the chapter states that limited data on hormonal suppression before IUI prevent a recommendation because benefits must be weighed against adverse effects and treatment delay. This paper is centrally about endometriosis — it focuses specifically on the effectiveness and limitations of IUI (with or without ovarian stimulation and pre-treatment hormonal suppression) for endometriosis-related infertility.

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Abstract

Although intrauterine inseminations (IUI) with or without superovulation have been widely used in treating endometriosis-related infertility, the available studies are limited by small sample size, experimental design, and heterogenous study populations. IUI is effective in improving fertility in women with stages I–II endometriosis compared with expectant management, and, in these patients, IUI preceded by controlled ovarian hyperstimulation results in higher pregnancy rates compared with IUI alone. IUI may be less efficacious in patients with stages III–IV compared with those with stages I–II, possibly because the anatomic distortion caused by endometriosis may impair fertility. Limited data are available on the role of hormonal suppression of endometriosis before IUI, and, therefore, it cannot be recommended because the potential improvement in pregnancy rates must be balanced with the adverse effects of treatment and the delay in the treatment. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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