Human Reproduction, Vol 13, 1553-1558, Copyright © 1998 by Oxford University Press
BJ Cohlen, ER te Velde, RJ van Kooij, CW Looman and JD Habbema
In this randomized crossover trial we investigated whether the use of
controlled ovarian hyperstimulation with low-dose human menopausal
gonadotrophin in couples with male subfertility leads to a higher
probability of conception when intrauterine insemination (IUI) is applied.
We also investigated whether the efficacy of IUI in natural or stimulated
cycles was related to the severity of male subfertility. Seventy-four
couples completed 308 treatment cycles. Thirteen pregnancies occurred after
IUI in a natural cycle (pregnancy rate per completed cycle: 8.4%) and 21
after IUI in a stimulated cycle (pregnancy rate per completed cycle:
13.7%). The difference between the two treatment modalities was not
statistically significant. The efficacy of IUI in stimulated cycles was
related to the severity of the semen defect. In couples with a total motile
sperm count < 10 x 10(6), ovarian stimulation did not improve treatment
outcome, while it did in couples with a total motile sperm count > or =
10 x 10(6). Compared with the expected chance of conceiving spontaneously
without treatment, both natural and stimulated cycles improved the
probability of conception. We conclude that, for the group as a whole,
ovarian stimulation did not improve the probability of conception. However,
in couples with less severe semen defects, ovarian stimulation did improve
the probability of conception.
ARTICLES
Controlled ovarian hyperstimulation and intrauterine insemination for treating male subfertility: a controlled study
University Hospital Utrecht, Department of Reproductive Medicine, The Netherlands.
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