Is Double Intrauterine Insemination (IUI) More Successful Than Single IUI?
Intrauterine insemination is a technique that is often recommended for couples with male infertility, unexplained infertility, sexual dysfunction, ovulatory dysfunction, or endometriosis. There has long been debate as to whether consecutive intrauterine inseminations are more effective than single intrauterine insemination. A review of the scientific literature suggests that with large homogeneous groups of infertile patients, there is very little difference in the live birth rates comparing double to single insemination. Therefore most infertility clinics recommend a single intrauterine insemination. Few studies have looked specifically at various sub-groups of infertile couples to determine if double inseminations might have a benefit.
A recent abstract presented at the 2013 Conjoint Meeting of the International Federation of Fertility societies and the American Society for Reproductive Medicine suggests that there may be an advantage to using back to back (double uterine inseminations) for couples with male factor infertility. The overall pregnancy rate considering all infertile patients in the study was 11% for the single IUI group compared to 12.8% for the double IUI group. However, when the investigators looked only at the sub-group of patients with male infertility, the clinical pregnancy rate for the single IUI group was 9.8% compared to 17.5% for the double IUI group. When they analyzed the outcomes according to the type of stimulation utilized for each patient, they found that within the male factor group, there was an even stronger benefit for double insemination. Specifically, when injectable ovarian stimulation medications (gonadotropins) were used, the double IUI group had a clinical pregnancy rate of 27.5% compared to 10.8% for the single IUI group. The double IUI included 40 patients while the single IUI group consisted of 101 patients.
If additional studies looking at larger groups of patients replicate these findings, couples undergoing IUI for male factor infertility should give serious consideration to double IUI.
Source: Couples With Male Factor Infertility Undergoing Gonadotropin/IUI Have Greater Clinical Pregnancy Rates With Double Vs. Single IUI; Thompson,S.M., Wright,E. et. al. Fertility and Sterility Supplement; September 2013.