EFFECT OF CONTROLLED OVARIAN HYPERSTIMULATION ON PREGNANCY RATES AFTER INTRAUTERINE INSEMINATION

OBJECTIVE: Our objective was to evaluate the effect of controlled ovarian hyperstimulation on pregnancy rates after intrauterine insemination of washed husband's sperm. STUDY DESIGN: In a private practice setting at the Infertility, Gynecology, and Obstetrics Medical Group in San Diego, 79 treatment programs included intrauterine insemination during natural cycles, 195 included clomiphene stimulation, and 53 had human menopausal gonadotropin stimulation. Pregnancy rates and monthly fecundabilities were calculated by life-table analysis and compared by the Z test. RESULTS: By life-table analysis the cumulative probability of pregnancy after intrauterine insemination with no ovulation induction is 21.0% after six cycles with a monthly fecundability of 3.4%. With clomiphene the pregnancy rate is 32.7% with a monthly fecundability of 6.1%, and with human menopausal gonadotropin the pregnancy rate is 60.7% with a monthly fecundability of 13.0%. The human menopausal gonadotropin group had a significantly higher pregnancy rate and monthly fecundability as compared with the other two groups. There were no differences between the no-stimulation and the clomiphene groups. CONCLUSIONS: Human menopausal gonadotropin stimulation results in a significantly higher pregnancy rate and monthly fecundability after intrauterine insemination as compared with no stimulation or clomiphene use.