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Human Reproduction, Vol. 16, No. 1, 96-101, January 2001
© 2001 European Society of Human Reproduction and Embryology

Vaginal misoprostol enhances intrauterine insemination

Samuel E. Brown1,3,5, James P. Toner1,4, John A. Schnorr1, Shaun C. Williams1, William E. Gibbons1, Dominique de Ziegler2 and Sergio Oehninger1

1 Department of Obstetrics and Gynecology, The Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA and 2 Hôpital de Nyon, Nyon and University Hospital Geneva, Geneva, Switzerland

This study examined whether the prostaglandin E1 analogue misoprostol (400 µg), when placed vaginally at the time of intrauterine insemination (IUI) improves pregnancy rates. A prospective, placebo-controlled, randomized and double-blind study involving 274 women in 494 IUI cycles resulted in a total of 64 pregnancies (13% per cycle). Misoprostol cycles totalled 253, with 43 pregnancies (17% per cycle), whereas placebo cycles totalled 241, with 21 pregnancies (9% per cycle). The cumulative pregnancy rate with misoprostol treatment was significantly greater than with placebo (P = 0.004, Cox proportional hazards regression). The benefit of misoprostol was seen in clomiphene cycles (14 versus 4%, P = 0.006), and was indicated in FSH cycles (33 versus 15%, borderline significance) and natural cycles (15.6 versus 7.7%, not significant), but was not seen in clomiphene/FSH cycles (18.2 versus 23.5%, not significant). Misoprostol treatment did not increase pain score on the day of IUI (1.1 versus 1.4) and at 1 day post IUI (0.6 versus 0.8). Complications were rare in both groups [six (2%) subject cycles in the misoprostol cycles compared with two (1%) in the placebo group]. It is concluded that the use of vaginal misoprostol may improve the chance for pregnancy in women having IUI in a wide variety of cycle types.

Key words: intrauterine insemination/misoprostol/pregnancy/prostaglandin/vaginal

3 Present address: Florida Institute for Reproductive Medicine, 836 Baptist Medical Center Pavilion, Jacksonville, FL 32207, USA

4 Present address: Atlanta Center for Reproductive Medicine, Woodstock, GA 30189, USA

5 To whom correspondence should be addressed at: Florida Institute for Reproductive Medicine, 836 Baptist Medical Center Pavilion, Jacksonville, FL 32207, USA. E-mail: sambrown99{at}yahoo.com


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Home page
 Hum ReprodHome page
J. Toner, D. de Ziegler, S. Brown, W. E. Gibbons, S. Oehninger, J. A. Schnorr, and S. C. Williams
High rates of cramping with misoprostol administration for intrauterine insemination
Hum. Reprod., May 1, 2001; 16(5): 1051 - 1051.
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