Comparison of intrauterine and intracervical insemination with frozen donor sperm: a meta-analysis

Objective: To determine whether artificial insemination with frozen donor s perm yielded a higher pregnancy rate per cycle by intracervical (ICI) or in trauterine (IUI) techniques. A meta-analysis was performed. Data Identification: A computerized MEDLINE search of the English-language literature on artificial insemination with donor sperm was performed and au gmented by a review of meeting abstract books and references in published p apers. Study Selection: Only prospective randomized studies that reported monthly fecundity rates for IUI and ICI with frozen donor sperm were included. Data Analysis: Seven studies were identified. The odds ratios (OR) and 95% confidence intervals (CI) were determined with use of the general estimatin g equation method for the three studies for which raw data could be obtaine d. For the remaining four studies, the OR and CI were assessed with use of the published summary data. A random-effects meta-analysis was then perform ed. Result: Intrauterine insemination resulted in a significantly higher monthl y fecundity rate with a common OR of 2.4 (CI 1.5-3.8). Conclusion: On the basis of this meta-analysis of the seven prospective stu dies, IUI results in higher pregnancy rates than ICI for frozen donor insem ination. (Fertil Steril(R) 1999;72:792-5. (C) 1999 by American Society for Reproductive Medicine.).