An open multicenter study to compare the efficacy of intraperitoneal insemination and intrauterine insemination following multiple follicular development as treatment for unexplained infertility

Purpose: This multicenter study was carried out to compare the efficacy of intrauterine insemination (IUI) and intraperitoneal insemination (IPI) associated with multiple follicular development as treatment for unexplained infertility.

A total of 205 couples completed the trial. Sixty-seven couples underwent treatment with IPI (group A) and 138 couples underwent treatment with IUI (group B).

Clinical pregnancy was obtained in 23 couples in group A (pregnancy rate: 34.3%) and in 36 couples in group B (pregnancy rate: 26.1%). No significant difference was observed between group A and group B. As for the evolution of pregnancies and the incidence of twin pregnancies, no significant difference was observed between the two groups.

Because IUI and IPI allow us to obtain same results and IPI is more invasive than IUI, the latter technique can be considered the method of choice and IPI should be used when IUI is difficult to perform, as in the presence of a tight cervical canal. Similar content being viewed by others

Melis GB, Paoletti AM, Strigini F, Menchini-Fabris F, Canale D, Fioretti P: Pharmacologic induction of multiple follicular development improves the success rate of artificial insemination with husband’s semen in couples with male-related or unexplained infertility. Fertil Steril 1987;47:441–445 Allen NC, Herbert CM III, Maxon WS, Rogers BJ, Diamond MP, Colston-Wents A: Intrauterine insemination: a critical review. Fertil Steril 1985;44:569–573 Forrler A, Dellenbach P, Nisand I, Moreau L, Cranz C, Clavert A, Rumpler Y: Direct intraperitoneal insemination in unexplained and cervical infertility. Lancet 1986;1:916–917 Cimino C, Guastella G, Camporetto G, Gullo D, Perino A, Benigno MA, Barba G, Cittadini E: Direct intraperitoneal insemination (DIPI) for the treatment of refractory infertility unrelated to female organic pelvic disease. Acta Eur Fertil 1988;19:61–65 Hovatta O, Kurumaki H, Tiitien A, Lahteenmaki P, Koskimies AI: Direct intraperitoneal or intrauterine insemination and superovulation in infertility treatment: A randomized study. Fertil Steril 1990;54:339 Crosignani PG, Walters DE, Soliani A: The ESHRE multicentre trial on the treatment of unexplained infertility: A preliminary report. Hum Reprod 1991;6:953–958 Evans J, Wells C, Gregory L, Walker S: A comparison of intrauterine insemination, intraperitoneal insemination, and natural intercourse in superovulated women. Fertil Steril 1991;56:1183–1187 Gregoriuo O, Papadias C, Konidaris S, Gargaropoulos A, Kalampokas E: A randomized comparison of intrauterine and intraperitoneal insemination in the treatment of infertility. Int J Gynaecol Obstet 1993;42:33–36 Karlstrom PO, Bergh T, Lundkvist O: A prospective randomized trial of artificial insemination versus intercourse in cycles stimulated with human menopausal gonadotropin or clomiphene citrate. Fertil Steril 1993;59:554–559 Melis GB, Paoletti AM, Ajossa S, Guerriero S, Depau GF, Mais V: Ovulation induction with gonadotropins as sole treatment in infertile couples with open tubes: A randomized prospective comparison between intrauterine insemination and timed vaginal intercourse. Fertil Steril 1995;64:1088–93 Armitage P, Berry G: Statistical Methods in Medical Research, 3rd ed. London, Blackwell Scientific, 1994 Manhes H, Hermabessier J: Fecondation intraperitoneale. Premiere grossesse obtenue sur indication masculine. Presented at the 3rd International Forum Andrology, Paris, 1985, p 32 (abstract) Tesarik J, Mendoza OC, Testart J: Effect of the human cumulus oophorus on movement characteristics of human capacitated spermatozoa. J Reprod Fertil 1990;88:665–675 Suarez SS, Wolf DP, Meizel S: Induction of the acrosome reaction in human spermatozoa by a fraction of human follicular fluid. Gamete Res 1986;14:107–121 Turhan NO, Artini PG, D’Ambrogio G, Droghini F, Volpe A, Genazzani AR: Studies on direct intraperitoneal insemination in the management of male factor, cervical factor, unexplained and immunological infertility. Hum Reprod 1992;7:66–72 Karlstrom P-O, Bakos O, Palmstierna M, Bergh T, Lundkvist O: Direct intraperitoneal insemination—Clinical results and comparison between two methods of sperm preparation. Fertil Steril 1991;56:939–945 Ragni G, Lombroso GC, De Laurentis L, Olivares MD, Cristiani C, Crosignani PG: Pregnancy after direct intraperitoneal insemination of spermatozoa from a man with severe infertility, after unsuccessful application of other methods of assisted fertilization. Hum Reprod 1990;5:225–226 Campos-Liete E, Insull M, Kennedy SH, Ellis JD, Sargent I, Barlow DH. A controlled assessment of direct intraperitoneal insemination. Fertil Steril 1992;57:168–173 Author information Authors and Affiliations Additional information The following persons from the Department of Obstetrics and Gynaecology, University of Cagliari, Cagliari, Italy, also contributed to the conduct and analysis of the study: V. Mais and A. M. Paoletti. Rights and permissions About this article Cite this article Ajossa, S., Melis, G.B., Cianci, A. et al. An open multicenter study to compare the efficacy of intraperitoneal insemination and intrauterine insemination following multiple follicular development as treatment for unexplained infertility. J Assist Reprod Genet 14, 15–20 (1997). https://doi.org/10.1007/BF02765745 Received: Accepted: Issue date: DOI: https://doi.org/10.1007/BF02765745