RETROSPECTIVE STUDY OF AN INTRA UTERINE I NSEMINATION PROGRAM WITH DONOR SEMEN

The results of 109 intra-uterine inseminations with cryopreserved prep ared donor semen (IUId) in stimulated cycles, performed among 42 coupl es from November 1987 to June 1991, were analysed. The single IUId was performed 39 +/- 3 hours after the injection of human chorionic gonad otrophin. For each IUID 1,25 +/- 1,4 x 10(6) motile spermatozoa (mean +/- standard deviation) were inseminated. 27 pregnancies were obtained and the pregnancy rate per cycle was 24,8 %. The number of motile spe rmatozoa inseminated was significantly higher in the group of pregnant women than in the population without pregnancy (1,64 x 10(6) / IUI ve rsus 1,13 x 10(6) / IUI). The sperm count and the number of motile spe rmatozoa inseminated were significantly higher when the semen was prep ared on discontinuous Percoll gradients than after swim-up in Menezo B 2 medium (8,2 x 10(6) / ml versus 4,3 x 10(6) / ml and 1,7 x 10(6) ver sus 0,77 X 10(6)). Among the 27 clinical pregnancies, 3 were twins and 2 were triplets. The ovarian hyperstimulation associated with the use of a prepared semen of donor, generate a high risk of multiple pregna ncies. To improve the results without increasing the risk of multiple pregnancies, we propose to inseminate about 1,5 x 10(6) motile spermat ozoa with a maximum plasma estradiol level of 1 100 pg / ml, on the da y of hCG injection, associated with 2 preovulatory follicles. This tec hnique may augment the rate of pregnancy and represents an appreciable time gain. These results must be confirmed by randomized prospective studies.