Preseed.com Blog

Inseminating sperm directly into the uterus (intrauterine insemination or IUI) is often used in male factor infertility, either with or without giving medication to stimulate the ovaries.  There have been a couple of papers this year of interest to me on this topic.  Many couples don’t fully realize how low the per cycle pregnancy rate with IUI can be, especially in conditions as noted below, or in clinics that aren’t very experienced in dealing with male factor patients (read more of my FAQs to learn about this).

Specifically, Badawy et al., 2008 showed declining pregnancy rates following IUI with  male factor if: the female partner was over 35 yrs old; the number of motile sperm inseminated was less than 5 million ( a 5.5%, pregnancy rate versus 24% if there were more than 5 million motile sperm); or if normal sperm morphology  (WHO guidelines) was under 30%.    Another recent study (Dovey et al., 2008) with over 4,000 couples found pregnancies from women under 35 years of age at 11.5% per cycle.  Women 35-37 had a pregnancy rate of 9% , which declined down to 1.8% in women over 42.  

This is why we recommend if you are 35 or older, do not wait for one year without conceiving to get assistance!

Many people do not believe that a doctor’s intervention is the right thing to do in conceiving, or perhaps they just can’t afford it.  It is interesting to note that although the percentage of women having a baby tends to be higher following intra-uterine insemination,  it has not been able to be proven to be more effective in clinical studies versus well timed natural intercourse (Cochrane Database Syst Rev., 2007 ).  This is likely due to the lack of well designed studies, rather than an ineffectiveness of IUI (done by experienced clinicians), BUT it does suggest that good old, natural love making at least every other day throughout your ovulation time, can be effective even after a long time of trying!  So even if you can’t or won’t do IUI, keep timing your ovulation and keep love making  “that time” as enjoyable as you can! Sometimes miracles do happen

Dr. E

PS: I will continue my male work-up series later this month!