Effect of Timing and Number of Intrauterine Insemination (IUI) on the Cycle Clinical Outcome

ObjectiveTo study the effect of timing and number of intrauterine insemination (IUI) per cycle on the outcome of artificial insemination by husband (AIH).MethodsA total of 195 infertile couples underwent 379 cycles of IUI with husband's sperm. They were divided into 4 groups according to the ovulation and the number of IUIs per cycle: single IUI was performed 24 h after hCG injection, including single IUI before ovulation (group A) and single IUI after ovulation (group B); double IUI was performed 24 h and 48 h after hCG injection, including double IUI before and after ovulation (group C) and double IUI before ovulation (group D). The relationship between IUI pregnancy rate and the factors like processed total motile sperm (PTMS), timing and number of IUIs per cycle was analyzed.ResultsWhen PTMS<5 × 106, only one case in group B got pregnant, while no pregnancy was observed in other groups. When PTMS ≥ 5 × 106, pregnancy rates in all group were improved significantly. The pregnancy rate in group B reached 32.22%, which was significantly higher than that in group A (14.12%), group C (20.00%) and group D (17.39%), respectively (P<0.05).ConclusionIUI treatment is recommended to be performed when PTMS ≥ 5 × 106. An ideal pregnancy rate can be achieved by single IUI which is performed 24 h after hCG injection, and double IUI performed without ovulation could not result in significant improvement of cycle pregnancy rate.