Does tenaculum application to the cervix during intrauterine insemination affect pregnancy rates?

Intrauterine insemination (IUI) consists of sperm cell extraction from seminal plasma and artificial transfer into the uterine cavity. We investigated whether tenaculum application to the cervix during IUI affects pregnancy rates. A prospective study was done on 468 primary infertile women. Recombinant follicle stimulating hormone was used in ovulation induction. The women were divided randomly into Group 1 (n=236) and Group 2 (n=232) without and with tenaculum application to the cervix, respectively. After IUI, a five-minute sagittal plane uterine ultrasound scan was done in all cases. Uterine contraction was recorded. The women were evaluated for pregnancy rates. Uterine contraction was significantly higher in Group 2 (p<0.001). In all, 24 patients in Group 1 (10.7%) and 38 in Group 2 (17.6%) achieved pregnancy (OR = 1.78, 95% CI 1.03-3.08; p=0.038). Tenaculum application to the cervix increases immediate uterine contraction, but higher pregnancy rates may be obtained.