Human Reproduction, Vol. 10, No. 7, pp. 1765-1774, 1995
© 1995 European Society of Human Reproduction and Embryology
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Andrology: Strategies in frozen donor semen procreation
1CECOS de l'Ouest CHR Hôtel Dieu, Rennes 2Service de Gynécologie-Obstétrique, Département de Gynécologie Obstetrique et Biologie de la Reproduction CHR Hôtel Dieu, Rennes 3Service de Gynécologie Obstétrique CHU Fontenoy, 35000 Rennes, France
Correspondence: 4To whom correspondence should be addressed at: Unité de Biologie de la Reproduction, CECOS de I'Ouest, CHR Hôtel-Dieu, I rue de la Cochardière, 35000 Rennes, France
Data were analysed from 710 couples who had been assessed to determine the effectiveness and the drawbacks of three different methods of insemination using frozen donor semen. Intracervical insemination (ICI) was the first method used when the women had no tubal disorder: 255 pregnancies were achieved in a total of 2558 cycles (10%). Intrauterine insemination (IUI) associated with ovarian stimulation resulted in 152 pregnancies over 966 cycles (16%). In-vitro fertilization (IVF) was proposed after 
12 insemination failures using either of the other methods or when the initial gynaecological examination had revealed abnormalities such as tubal occlusions; 48 pregnancies were obtained in 262 cycles (18.3%). The pregnancy rate using ICI was significantly higher when two inseminations were performed per cycle, compared with one insemination per cycle (12.3 versus 7%, P < 0.001). The number of motile spermatozoa per straw was correlated with the pregnancy rate when using ICI, rising from 9% with <4X106 motile spermatozoa to 13.8% with 4–8X106 and 17.2% with >8X106. No relationship was found between the number of motile spermatozoa and the pregnancy rate using IUI and IVF. The incidence of primary ovulatory disorder was higher among women whose husbands were oligozoospermic than among those whose husbands were azoospermic (19 versus 9%, P < 0.01), but ovarian stimulation improved the fecundity of subfertile women. The outcome of pregnancies was also analysed for the three methods. From these data, strategic plans have been proposed to maximize the pregnancy rate for women undergoing therapeutic donor insemination with frozen semen.
Key words: frozen donor semen/intracervical insemination/intrauterine insemination/IVF
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