The successful use of hyperstimulated washed therapeutic donor insemination after standard therapeutic donor insemination has failed.

OBJECTIVE

To investigate whether an aggressive therapeutic donor insemination regimen (stimulated folliculogenesis and ovulation plus intrauterine insemination) can produce a better fecundability rate than a more traditional insemination regimen (non-stimulated folliculogenesis plus LH-timed intracervical insemination) in women who have failed to become pregnant during an initial series of six traditional insemination cycles.

DESIGN

A retrospective comparison of fecundability rates was undertaken between women undergoing the traditional insemination protocol and those who voluntarily switched to ovarian hyperstimulation coupled with intrauterine insemination.

PARTICIPANTS

Eight-two women who failed to become pregnant during an initial series of six intracervical insemination cycles.

RESULTS

Fecundability was 5.6% in cycles of continued urinary LH-timed intracervical insemination and 19.4% when the more aggressive regimen was applied. The difference in fecundability between protocols was significant (P < .005).

CONCLUSION

After an initial series of donor inseminations has failed, a more aggressive insemination regimen involving ovarian hyperstimulation followed by washed intrauterine insemination provides a higher fecundability rate than continued intracervical insemination.