Intrauterine Insemination vs Timed Intercourse in Letrozole and FSH-stimulated Cycles in Dysovulatory Infertility

Abstract

Background: Dysovulatory infertility is a major cause of infertility. It is treated with ovulation induction complemented with an assisted reproductive technique such as intrauterine insemination (IUI) and timed intercourse (TI). The data to compare the efficacy of IUI vs TI in super-ovulated cycles is limited. Aim: Comparison of pregnancy rates following IUI vs TI in letrozole and follicle-stimulating hormone (FSH) cycles in dysovulatory infertility. Method: Following the history and examination of subjects enrolled, baseline hormonal levels were done on day 2, transvaginal ultrasonography (TVS) for number and size of follicles and endometrial thickness was done on days 8, 10, and 12, and ultrasonography (USG) to confirm ovulation was done on day 14, if confirmed, it was followed by IUI or TI. Urine pregnancy test (UPT) at 2 weeks established successful conception. Those not conceiving received another cycle, to a maximum of 3 cycles. Result: A total of 120 subjects received 320 cycles. Intrauterine insemination shows better conception rates than TI (p-value < 0.05). The clinical pregnancy rate for the IUI group is 18.5% (28 in 154 cycles) and 10% (16 in 166) in the TI group. The success rate is positively correlated with younger age of patients, better educational status, and higher socioeconomic status. Conclusion: Intrauterine insemination combined with letrozole and FSH-stimulated dysovulatory infertility is an effective method to improve pregnancy outcomes.