Comparison of Intrauterine Tuboperitoneal Insemination and Intrauterine Insemination on Pregnancy Rate : Preliminary Report

Abstract

Background and objective: Intrauterine insemination (IUI) after ovarian stimulation with clomiphene citrate has been a mainstay of therapy for couples suffering from non-tubal infertility because IUI is a simple, non-invasive, and cost-effective technique. Pregnancy rates after IUI were 8% to 15% on the average. Although the number of available follicles was increased by ovarian stimulation, the results are still not very promise. Because the clinical pregnancy rate of IUI in Srinagarind Hospital was 3.08%. The new insemination method for improving the clinical pregnancy rate was considered to be an alternative way technique which could be reduced cost and duration of treatment and avoid complication of the assisted reproductive technology. A preliminary RCT compared the clinical pregnancy rate of IUTPI and IUI was the main objective of the study.

Methods: The study was conducted from April 1, 2007 to March 31, 2008 at Infertility clinic, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. The volunteers were women with non-tubal infertility who met the inclusion criteria (unexplained infertility, minimal-mild endometriosis, mild oligozoospermia) and undergoing first treatment cycle were randomized to the study. Twenty eight women were randomized to the study and allocation to group A (IUTPI) or group B (IUI) on the day of insemination followed the ovarian stimulation with clomiphene citate (CC). On the day of 36-40 hours after hCG administration, IUTPI was performed by using a pediatric Foley's catheter size 8 F inseminating with 10 mL of sperm suspension and IUI was performed with 0.5 mL of sperm suspension by using the household IUI catheter.

Results: A total of 28 cycles was completed treatment and followed up (16 IUTPI cycles and 12 IUI cycles).The clinical pregnancy rate per cycle was 6.3%(1/16) for IUTPI and 0%(0/12) for IUI, p=1.00. The ongoing pregnancy rate per cycle was 6.3%(1/16) for IUTPI and 0%(0/12) for IUI, p=1.00. No multiple pregnancy, ectopic pregnancy, ovarian hyperstimulation syndrome and infection were occurred.

Conclusion: This preliminary result of IUTPI after ovarian stimulation with clomiphene citrate might not be advantage over the standard IUI for couples with non-tubal infertility on pregnancy rate.

Keywords: Intrauterine tuboperitoneal insemination, intrauterine insemination, clinical pregnancy rate, ongoing pregnancy rate