SUCCESS OF INTRAUTERINE INSEMINATION USING CRYOPRESERVED DONOR SPERM IS RELATED TO THE AGE OF THE WOMAN AND THE NUMBER OF PREOVULATORY FOLLICLES

Objective: Our objective was to assess parameters associated with a su ccessful outcome of intrauterine insemination (IUI) using cryopreserve d donor sperm. Design: We analyzed 750 consecutive donor IUI cycles un dertaken by 363 women in an assisted conception clinic. The main outco me measure was clinical pregnancy. Results IUI was performed in 94.7% of the 750 IUI treatment cycles commenced and 180 clinical pregnancies occurred. The clinical pregnancy rare per cycle was 26.4%. The rate w as significantly related to the patient's age (30.5% for age less than or equal to 35 years and 181% for age less than or equal to 35 years; P < 0.006) and whether there was one or more than one preovulatory fo llicles [20.9, 34.4, and 31.5% for one, two, and three or four follicl es with a mean diameter of 14 or more mm at the time of human chorioni c gonadotropin (hCG) administration; P = 0.006]. Two to four preovulat ory follicles were present in 12.6% of the natural cycles, 43.6% of cl omiphene citrate or tamoxifen, and 59.9% of gonadotropin stimulated cy cles. The difference in the number of preovulatory follicles between s timulated and unstimulated cycles was highly significant (P < 0.0001). Pregnancy rates were 29.9% in gonadotropin-stimulated cycles, 23.6% i n clomiphene citrate- or tamoxifen-stimulated cycles, and 20.1% in uns timulated cycles. The difference in pregnancy rates between gonadotrop in-stimulated and natural cycles was significant (P = 0.038). Cycle fe cundity rates were not significantly affected by the number of previou s treatment cycles, duration of infertility, gravidity and parity of t he patient, presence of a spontaneous luteinizing hormone (LH) surge b efore the administration of hCG, or number of motile sperm in the inse mination specimen. Conclusions: Success of IUI using cryopreserved don or sperm is related to the age of the women and whether there is one o r more than one preovulatory follicles.