Intrauterine Technique Makes Pregnancy More Likely
WebMD News Archive
Dec. 6, 1999 (Los Angeles) -- Intrauterine insemination (IUI) with frozen
donor sperm more than doubles a woman's chances of conceiving over
intracervical insemination (ICI), according to a paper in the November issue of
the journal Fertility and Sterility. "The point of our study is to
make people aware that there is a difference. There's really no reason not to
do IUI," lead author Jeffrey Goldberg, MD, tells WebMD.
With ICI, semen is simply injected into the cervical canal, while for IUI,
the sperm must be separated from the semen before it is deposited directly into
Goldberg, who is director of the In Vitro Fertilization Program at the
Cleveland Clinic, and his colleagues conducted an analysis of studies that
provided monthly success rates for IUI and ICI and that used only frozen donor
sperm. They searched a database dating back to 1966 and reviewed books from
various medical meetings dating from 1990 for unpublished studies. In all,
seven studies met their criteria. The authors then contacted the investigators
of those studies in the hopes of obtaining the original raw data, and were
successful in three cases.
For the combined raw data and reported results, a woman's odds of becoming
pregnant on a given insemination attempt were estimated to be 2.4 times higher
for those using IUI, the authors report, possibly because IUI may deliver more
mobile sperm to the site of fertilization.
"I absolutely agree with the findings of this study -- that's been our
experience," says Daniel B. Williams, MD, associate professor, division of
reproductive endocrinology and infertility at Washington University School of
Medicine in St. Louis. Williams, who was one of the investigators to share
their raw data for this analysis, tells WebMD that "at this point I would
be surprised if any clinician were still doing intracervical
One drawback is that IUI is more expensive. However, says Williams, "the
extra cost can be justified in terms of the increased pregnancy rates."
Says Goldberg, "since you're more than doubling your chances of pregnancy,
IUI is very cost-effective." He estimates that one attempt of IUI costs
$100-$200 more than a comparable cycle of ICI. There are no adverse effects and
no contraindications to IUI if frozen sperm is used, and it is comparable to
getting a Pap smear in terms of patient discomfort and time. He and his
co-authors conclude that "Intrauterine insemination should be the preferred
technique for artificial insemination with frozen donor sperm."