Tubal surgery and subsequent artificial insemination by donor.

The conception rate of 32 infertile women undergoing tubal microsurgery and subsequent artificial insemination by donor (AID) was compared with that of 71 women undergoing tubal microsurgery alone. The follow-up period ranged from 1 to 6 1/2 years. Nine (28%) of the patients in the AID group conceived, resulting in 8 (89%) live births and 1 (11%) spontaneous abortion. In the normal semen group 42 (59%) of the patients conceived, resulting in 31 (74%) live births, 6 (14%) tubal pregnancies and 5 (12%) spontaneous abortions. In the AID group the following term pregnancy rates were achieved: 40% after bilateral lysis of periadnexal adhesions, 25% after fimbriolysis and 14% after salpingostomy. The corresponding figures in the group with normal semen analysis was 67%, 64% and 29%, respectively. It is concluded that patients who in addition to tubal microsurgery have been treated with AID for 9-12 menstrual cycles seem to have about a 50% poorer chance of achieving a term pregnancy compared with patients whose husbands have normal semen quality.