A RANDOMIZED AND LONGITUDINAL-STUDY OF HUMAN MENOPAUSAL GONADOTROPIN WITH INTRAUTERINE INSEMINATION IN THE TREATMENT OF INFERTILITY

Objective: To study in a randomized and longitudinal manner the effica cy of human menopausal gonadotropin (hMG) superovulation combined with intrauterine insemination (IUI) versus IUI alone in the treatment of various causes of infertility in the presence of normal ovulation. Met hods: An initially randomized and subsequently longitudinal study of i nfertile couples was performed at a university-based clinical research center. One hundred nineteen couples with longstanding infertility (a verage duration 3.7 years) associated with male factor infertility, un explained infertility, and/or endometriosis were enrolled. All patient s were randomized in the initial cycle to treatment with either hMG/IU I or urine LH-timed IUI alone. They were then followed longitudinally as they alternated subsequent cycles between the two modalities. Outco me indices measured were cycle fecundity, pregnancy outcome, and cumul ative pregnancy rates evaluated by life-table analysis. Results: Human menopausal gonadotropin/IUI therapy was consistently more effective t han IUI alone in the treatment of endometriosis, male factor infertili ty, and unexplained infertility, with cycle fecundities ranging from 7 .1-19.0% versus 0-6.7%, respectively, during the first seven cycles. C onclusion: Human menopausal gonadotropin/IUI is a more effective thera py for enhancing fertility than is IUI alone for the treatment of endo metriosis, male factor infertility, and unexplained infertility.