Objective: To evaluate the impact of luteal phase support with vaginal progesterone on pregnancy rates in the intrauterine insemination (IUI) cycles, stimulated with clomiphene citrate and human menopausal gonadotropin (hMG), in sub fertile couples.Materials and methods: This prospective, randomized, DOUBLE blind study was performed in a tertiary infertility center from March 2011 to January 2012. It consisted of 253 sub fertile couples undergoing ovarian stimulation for IUI cycles. They underwent ovarian stimulation with clomiphene citrate (100 mg) and hMG (75 IU) in preparation for the IUI cycle. Study group (n=127) received luteal phase support in the form of vaginal progesterone (400 mg twice a day), and control group (n=126) received placebo.Clinical pregnancy and abortion rates were assessed and compared between the two groups.Results: The clinical pregnancy rate was not significantly higher for supported cycles than that for the unsupported ones (15.75% vs.12.69%, p=0.3). The abortion rate in the patients with progesterone luteal support compared to placebo group was not statistically different (10% vs.18.75%, p=0.45).Conclusion: It seems that luteal phase support with vaginal progesterone was not enhanced the success of IUI cycles outcomes, when clomiphene citrate and hMG were used for ovulation stimulation.

BACKGROUND: There are many factors that affect intrauterine insemination (IUI) success rate and identifying those factors can be helpful. This study aimed to investigate the single versus DOUBLE IUI in controlled ovarian hyperstimulation cycles.METHODS: This is a randomized clinical trial with equal randomization (1:1) conducted on 580 women who underwent IUI in a private infertility clinic from May 2013 to November 2014 in Rasht, Iran. Women were randomly assigned to single (n=290) or DOUBLE (n=290) IUI groups. Women in the single group underwent IUI performed 36 h after human chorionic gonadotropin (HCG) administration. Women in the DOUBLE group underwent two IUIs performed 18 and 40 hours after HCG administration. The main outcome was clinical pregnancy confirmed by evidence of fetal cardiac activity. Data were analyzed by SPSS software. Comparisons of frequencies were done using the Fisher exact test and Chi-square test. For comparing means between the two groups, the independent t-test was used. The P-value < 0.05 was considered to indicate statistical significance.RESULTS: Pregnancy rate was 11.7% (34.290) in the single IUI group and 13.4% (39.249) in the DOUBLE IUI group. The difference between the two groups was not statistically significant (P=0.617, OR=1.17, 95% CI: 0.72-1.91). Also, we could not show significant difference between single and DOUBLE IUI groups in different cause of infertility groups regarding the success rate.CONCLUSION: Based on findings, DOUBLE versus single IUI did not increase the pregnancy rate of IUI and further investigations are recommended.

Objective: IUI is frequently used as a first line strategy in the treatment of infertile couples because of its relatively low cost and simplicity. Unfortunately, this cooperation without considering enough standard laboratory equipments, materials, and methods leads to unexpected and risky results which are not desirable. Because of preventing undesirable results it should be done in the hands of expert and knowledgeable persons. As it can be performed efficiently in the office and does not require sophisticated equipment (but standard) for diseases such as endometriosis, male infertility and anovulation. Predictive sperm parameters and threshold values with respect to semen characteristics for successful intrauterine insemination have been controversial; although the world health organization’s reference values for semen analysis are often use to assess sperm quality. More often pregnancies which are not successful with IUI have been achieved in sub fertile couples with sperm parameters below reference values listed in the W.H.O. manual. One of the most important parameters in a successful IUI is the precise knowledge of cooperative lab. About the full structure and morphology of sperm The sample should be processed under standard conditions to avoid using all the negative parameters and shocks, in order to gaining a desirable outcome. Sperm processing techniques for IUI vary from laboratory to laboratory and even from patient to patient. IUI has been used with variable success for the treatment of numerous indications in the infertile couples. Accordingly several semen parameters have been essential for successful IUI as mentioned below: 1. the semen should have the minimal reference values of W.H.O. 2. T.S.M. In the first and processed sample has important prospective. 3. Material and method should be standard and done in a standard lab. 4. Speed and forward progression percentage of sperms. 5. Making the right decision for choosing ether of swim up or gradient method for sperm processing. 6. Knowing the probable defects on a fetus due to laboratory mistakes. Materials and Methods: Prospective studyResults: there should be a permanent observation and contribution between the lab responsible for IUI and responsible performed IUI clinicsConclusion: without consideration of obligate steps for IUI, there might be the risk of genetic defects in the children who were born after such IUI performances.