Evaluation of intrauterine insemination practices: a 1-year prospective study in seven French assisted reproduction technology centers.

ABSTRACT

OBJECTIVE: To determine the best practices of intrauterine insemination with the partner's fresh sperm. DESIGN: Prospective multicenter observational study. SETTING: Assisted reproduction technology (ART) centers. PATIENT(S) Seven hundred and seven patients entering the program, regardless of age or cause of infertility. INTERVENTION(S) Intrauterine insemination by standard procedures. MAIN OUTCOME MEASURE(S) Effect of patient characteristics (duration of infertility, indications, age, parity, body mass index, semen parameters) as well as IUI parameters on delivery rates per couple or per attempt. RESULT(S) The overall live birth rate was 11.4% per cycle, varying from 8.4% to 17.6% between centers. The main differences in practice that had a statistically significant impact on the delivery rate were the use of gonadotropin-releasing hormone (GnRH) antagonists (15.2% with versus 9.4% without) and the number of mature recruited follicles (9.4% for one versus 15.2% for two). CONCLUSION(S) Our results indicate that the use of GnRH antagonists has a positive effect on the delivery rate, especially in the multifollicular stimulations that are required when women are older than 27 years.