Intrauterine insemination and ovulation stimulation as treatment of infertility.

Fecundity rates were measured for 302 patient-couples in 991 cycles of intrauterine insemination (IUI) between January 1984 and December 1986 in terms of the diagnoses and whether human menopausal gonadotropin (hMG) was also employed. Those rates were compared with the fecundity rates in 255 of the couples followed in 2,668 untreated cycles. IUI was most beneficial for cervical factor infertility, with a monthly yield of 0.11 in conjunction with hMG and for poor postcoital tests in general but was less impressive when seminal parameters were abnormal. The addition of hMG when ovulation was normal (as an independent variable) did not yield results statistically superior to those of IUI alone (fecundity = 0.06 versus 0.03), but the addition of hMG to the regimen gave an improvement over IUI alone when endometriosis had been diagnosed and in the presence of cervical factor infertility. One serious side effect of therapy was a pelvic abscess, which required hospitalization but not surgery.