Pregnancy rates after slow-release insemination (SRI) and standard bolus intrauterine insemination (IUI) – A multicentre randomised, controlled trial

Abstract

This multicentre, randomised, controlled cross-over trial was designed to investigate the effect of intrauterine slow-release insemination (SRI) on pregnancy rates in women with confirmed infertility or the need for semen donation who were eligible for standard bolus intra-uterine insemination (iUi). Data for a total of 182 women were analysed after randomisation to receive IUI (n = 96) or SRI (n = 86) first. The primary outcome was serological pregnancy defined by a positive beta human chorionic gonadotropin test, two weeks after insemination. Patients who did not conceive after the first cycle switched to the alternative technique for the second cycle: 44 women switched to IUI and 58 switched to SRI. In total, there were 284 treatment cycles (IUI: n = 140; SRI: n = 144). Pregnancy rates following SRI and IUI were 13.2% and 10.0%, respectively, which was not statistically significant (p = 0.202). A statistically significant difference in pregnancy rates for SRI versus IUI was detected in women aged under 35 years. In this subgroup, the pregnancy rate with SRI was 17% compared to 7% with IUI (relative risk 2.33; p = 0.032) across both cycles. These results support the hypothesis that the pregnancy rate might be improved with SRI compared to standard bolus IUI, especially in women aged under 35 years.

Factors influencing pregnancy outcome with special attention to modified slow-release insemination and a patient-centred approach in a donor insemination programme: a prospective cohort study

“…Previous reports showed that a slow-release intrauterine insemination might improve the pregnancy rate compared to bolus IUI. In these studies, a commercially available product was used (Grasby auto-syringe driver or the EVIE Slow-Release Insemination Pump) (Muharib et al, 1992;Marschalek et al, 2017Marschalek et al, , 2020.…”

Improving IUI success by performing modified slow-release insemination and a patient-centred approach in an insemination programme with partner semen: a prospective cohort study

“…Moreover, results of a multicentre, randomised controlled trial, comparing bolus IUI with SRI with duration of 4 hours, were recently reported by the same authors, using the same EVIE device (Marschalek et al, 2020). At total of 182 women were randomised to receive bolus-IUI (n = 96) or SRI (n = 86).…”

“…Previous reports showed that a slow-release intrauterine insemination (SRI) might improve the pregnancy rate when compared to bolus IUI. In these studies, a commercially available product was used (Grasby auto-syringe driver or the EVIESlow- Release Insemination Pump) ( Muharib et al, 1992 ; Marschlek et al, 2017 , 2020 ).…”

Should couples with unexplained infertility have three to six cycles of intrauterine insemination with ovarian stimulation or in vitro fertilization as first-line treatment?

“…Previous reports had shown that a slow-release IUI might improve the pregnancy rate compared with bolus IUI (5,6). We compared ongoing pregnancy rates after bolus IUI versus patient-friendly slow-release IUI.…”