Human Reproduction, Vol 12, 2162-2166, Copyright © 1997 by Oxford University Press
KW Fuh, X Wang, A Tai, I Wong and RJ Norman
The optimal time period for intrauterine insemination (IUI) in relation to
either luteinizing hormone (LH) surge or human chorionic gonadotrophin
(HCG) administration leading to the best pregnancy rates has not been
determined. In this study, 856 consecutive human menopausal gonadotrophin
(HMG)-stimulated and 49 natural unstimulated IUI cycles carried out at a
reproductive medicine unit affiliated with a tertiary centre were analysed
in a retrospective fashion. There were three scenarios in the temporal
relationship of the LH surge, HCG administration and artificial
insemination. These were (group A) subjects who had an endogenous LH surge
but were not given HCG; (group B) subjects who were given HCG after an
observed LH surge, and (group C) subjects who were given HCG before the LH
surge. The overall pregnancy rate (PR) was 16% per cycle. The PR was 9% in
group A, 20% in group B and 14% in group C. The PR in group B was
significantly better than group C (P = 0.04). In group B, the longer the
time interval between the LH surge and HCG administration, the better the
PR up to 20 h (P = 0.025); the timing of IUI based on the LH surge was not
critical to the achievement of pregnancy within 3 days. In group C, PR
improved with the increasing interval between HCG and IUI from <28 h up
to 60 h. We conclude that a better PR is achieved if a spontaneous LH surge
occurs before HCG administration, especially where the administration of
HCG is delayed 8-20 h after an observed LH surge; the timing of IUI based
on the LH surge is not critical to the achievement of pregnancy within 3
days.
ARTICLES
Intrauterine insemination: effect of the temporal relationship between the luteinizing hormone surge, human chorionic gonadotrophin administration and insemination on pregnancy rates
Dept of Obstetrics and Gynaecology, University of Adelaide, The Queen Elizabeth Hospital, Woodville, Australia.
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