A 3 YEAR RETROSPECTIVE REVIEW OF INTRAUTERINE INSEMINATION, USING CRYOPRESERVED DONOR SPERMATOZOA AND CYCLE MONITORING BY URINARY OR SERUM LUTEINIZING-HORMONE MEASUREMENTS

Insemination with donor spermatozoa is an integral part of infertility treatment. For the last 3 years in our unit, intrauterine inseminatio n with donor spermatozoa (IUID) has been used in preference to vaginal insemination, In this retrospective study, patients were offered an i nitial course of five single intrauterine inseminations with cryoprese rved donor spermatozoa and treatment was then reviewed. A total of 389 patients received 1465 inseminations, In all, 1119 cycles were monito red using luteinizing hormone serum analyses and 346 cycles using the urine home test kits. The clinical pregnancy rate per insemination for the cycles monitored by the serum assay was 18.0% (202/1119) compared with the urine cycles (13.7%, 46/346) (P <05), The pregnancy loss rat e was not significantly different (14.4%, 29/202 and 21.7%, 10/46) (se rum and urine cycles respectively). The viable clinical pregnancy rate was significantly higher (P <03) for the serum cycles than for the cy cles using the urinary monitoring (15.5%, 173/1119 and 10.4%, 36/346 r espectively). The cycles monitored by serum assay had a significantly higher cumulative viable clinical pregnancy rate (P <0001) of 70.2% af ter nine inseminations compared with the urine monitored cycles of 54. 8%. The majority of patients opted for the serum cycles,,vith a minori ty self-selecting the urine cycles mainly for travelling convenience. The explanation for the significant differences between the viable cli nical pregnancy rates per insemination and the cumulative viable clini cal pregnancy rates may be due to the sensitivity of the urine home te st kit or the patients' interpretation of the result.