Does transcervical intra-fallopian insemination improve pregnancy rates incases of oligoteratoasthenozoospermia? A prospective, randomized study

The relatively low pregnancy rates (PR) after treatment of patients with ol igoteratoasthenozoospermia (OTA) result in a search for different treatment modalities. The objective of this study was to assess the efficacy of tran scervical intrafallopian insemination (IFI) with husband's semen in compari son to intrauterine insemination (IUI) in couples with OTA. A prospective, randomized study included 30 couples with OTA-related infertility (accordin g to WHO criteria). The female patients underwent individually adjusted con trolled ovarian stimulation by gonadotropins. Spermatozoa was prepared usin g the Percoll 70% technique and insemination was performed 36-40 h after hu man chorionic gonadotropin (HCG) administration. The Tomcat Catheter was us ed for IUI and the Jansen-Anderson Catheter for IFI to the fallopian tube l eading to the ovary that contained more dominant follicles. The couples wer e divided according to sperm count, into group A (9 couples): <10 mill ml(- 1) and group B (21 couples): >10 mill ml(-1). Within the groups the patient s were randomly assigned for IUI or IFI treatment. Among group B couples, t wo pregnancies out of 15 IUI cycles (13.3% PR) and two pregnancies out of 1 8 IFI cycles (11.1% PR) were achieved. Group A patients completed 7 IUI and 9 IFI treatment cycles with no pregnancies observed. These data did not de monstrate a statistically significant advantage for either technique.