Treatment of refractory infertility by transcervical intrauterine insemination of washed spermatozoa

Artificial Insemination with Husband'S Sperm (Aih): Techniques for Sperm Selection

“…The most frequent indication and at the same time the most widely argued is male factor infertility or infertility due to poor quality of the male sperm. Controversy arises when setting the criteria of poor quality sperm through substandard parameters, such as oligospermia, asthenospermia, or oligoasthenospermia [3, 13, 20, 27, 28, 44, 501, or poor results in the zona-free hamster egg sperm penetration assay [32, 501. The second indication for AIH is the so-called "cervical factor" [2,6,7,10,23,26,38,44, 501. Despite a normal ovulatory cycle and adequate estrogenic level, cervical mucus inadequate in quantity or quality may be unsuitable for sperm transport.…”

“…Some authors have indicated AIH in cases in which all infertility investigations seemed to be normal and the couple had a long-time infertility history, classifying this type of infertility as "idiopathic or unexplained" infertility [6,10,44,491.…”

“…However, Confino et al [7] and Hull et al (231 did not register pregnancies in a total of 35 treated couples. When the cervical factor was the indication for intrauterine artificial insemination [6,7,23, 441, 31 pregnancies in 81 couples were achieved (pregnancy rate, 38%). The results in cases of idiopathic or unexplained infer-'tility [6,10,44,491 were eight pregnancies in 23 couples (pregnancy rate, 34 %) .…”

Comparison of Pregnancy Rate in Simultaneous Human Chorionic Gonadotropin Administration with Intrauterine Insemination Vs. Standard intrauterine Insemination

“…Although higher number of spermatozoa does not increase the likelihood of success of IUI, IUI success will be very low with less than one million motile sperm. Probably successful IUI is associated with increased total number of motile spermatozoa beyond a threshold of approximately 10 million (3,4). In addition to male factors, ovulatory dysfunction, uterus cervical factors and idiopathic infertility are also other indications for IUI (5).…”

“…Pregnancy rate drops off significantly (may be to zero) the day after ovulation. According to many references, presence of sperm in the genital tract the day before fertilization increases fertilization rate to the highest rate close to 30 percent (1,3). One of the major problems in IUI cycles is premature LH elevation and releasing of oocytes before the time set for IUI and opportunity loss for sperm entering into the female reproductive tract and fertilization (6).…”