Factors determining successful intrauterine insemination

Parul Sinha, Kiran Pandey, Anand Srivastava


Background: Infertility is defined as failure to conceive even after one year of regular, frequent and unprotected intercourse. Infertility can be attributed to male causes in approximately 25-40% cases, female causes in 40-50% cases, both in 10-20% and unexplained causes in 10-15% cases. Artificial insemination (Intrauterine Insemination) involves placement of processed sperms from husband (AIH – artificial insemination homologous) or from donor (AID – artificial insemination donor) into the female genital tract.

Methods: Objectives of the study were to do sperm preparation to obtain normal good quality motile sperms, to perform intrauterine insemination using husband semen around the time of ovulation, to study factors responsible for successful pregnancy rates by this method. Out of 100 infertile females recruited for the study 34 underwent artificial insemination by IUI with controlled ovarian hyper stimulation. Sperms were washed by density gradient centrifugation or by a direct swim-up technique that does not involve centrifugation.

Results: Overall pregnancy rate per patient for male factor infertility was 23.52%. None of the patients consented for more than three cycles of IUI. Maximum pregnancy was achieved in third cycle of IUI. Sperm motility >40% was related with pregnancy in 8 cases. Duration of infertility didn’t influence pregnancy rate. The majority of pregnancies were achieved in the age group of 25-29 years (50%). No pregnancy occurred with >15 years of infertility.

Conclusions: This study concluded that intrauterine insemination after ovarian stimulation or controlled ovarian hyperstimulation is a successful and efficacious therapy for infertility.


Infertility, Intrauterine insemination, Semen analysis

Full Text:



Cantineau AE, Cohlen BJ, Al-Inany H, Heineman MJ. Intrauterine insemination versus fallopian tube sperm perfusion for non tubal infertility. Cochrane Database Syst Rev. 2004:CD001502.

Dorjpurev U, Kuwahara A, Yano Y, Taniguchi T, Yamamoto Y, Suto A et al. Effect of semen characteristics on pregnancy rate following intrauterine insemination. J Med Invest. 2011;58:127-133.

World Health Organization, Department of Reproductive Health and Research. WHO laboratory manual for the Examination and processing of human semen. 5th Ed. 2010.

Younglai EV, Holt D, Brown P, Jurisicova A, Casper RF. Sperm swim-up techniques and DNA fragmentation. Hum Reprod. 2001;16(9):1950-3.

Templeton AA, Penney GC. The incidence, characteristics, and prognosis of patients whose infertility is unexplained. Fertil Steril. 1982;37(2):175-82.

Allen NC, Herbert CM, Maxson WS, Rogers BJ, Diamond MP, Wentz AC. Intrauterine insemination: a critical review. Fertil Steril. 1985;44(5):569-580.

Chaffkin LM, Nulsen JC, Luciano AA, Metzger DA. A comparative analysis of the cycle fecundity rates associated with combined human menopausal gonadotropin (hMG) and intrauterine insemination (IUI) versus either hMG or IUI alone. Fertil Steril. 1991;55(2):252-7.

Dickey RP, Pyrzak R, Lu PY, Taylor SN, Rye PH. Comparison of the sperm quality necessary for successful intrauterine insemination with World Health Organization threshold values for normal sperm. Fertility and Sterility. 1991;71:687-9.

Matorras R, Corcóstegui B, Perez C, Mandiola M, Mendoza R, Rodríguez-Escudero FJ. Sperm morphology analysis (strict criteria) in male infertility is not a prognostic factor in intrauterine insemination with husband's sperm. Fertil Steril. 1995;63(3):608-11.

Huang HY, Lee CL, Lai YM, Chang MY, Wang HS, Chang SY et al: The impact of the total motile sperm count on the success of intrauterine insemination with husband's spermatozoa. J Assist Reprod Genet. 1996;13:56-63.

Campana A, Sakkas D, Stalberg A, Bianchi PG, Comte I, Pache T et al. Intrauterine insemination: evaluation of the results according to the woman's age, sperm quality, total sperm count per insemination and life table analysis. Hum Reprod. 1996;11:732-6.

Byrd KJ. Supracervical replacement of spermatozoa. Ir. Soules MR (Ed.): Controversies in reproductive endocrinology and infertility. Elsevier, Amsterdam;1989.

Yavuz A, Demirci O, Sözen H, Uludoğan M. Predictive factors influencing pregnancy rates after intrauterine insemination. Iran J Reprod Med. 2013;11(3):227-34.

WesterkalenLA, Naaktgeboren N, Helmerhorst FM. Evaluation of pregnancy rates after intrauterine insemination according to indication, age and sperm parameters. Assist Repro Genet J. 1998;15:359-64.

Dinelli L, Courbière B, Achard V, Jouve E, Deveze C, Gnisci A, Grillo JM, Paulmyer-Lacroix O. Prognosis factors of pregnancy after intrauterine insemination with the husband's sperm: conclusions of an analysis of 2,019 cycle. Fertil Steril. 2014;101(4):994-1000.

Brezechffa PR, Daneshmand S, Buyalos RP. Sequential clomiphene citrate and human menopausal gonadotrophin with intrauterine insemination: the effect of patient age on clinical outcome. Hum Reprod. 1998;13:2110-4.

Zeyneloglu HB, Arici A, Olive DL et al Comparison of Intrauterine Insemination with Timed Intercourse in Superovulated Cycles with Gonadotropins: A Meta-analysis. Fertil Steril. 1998; 69: 486-91.