Influence of ultrasound-guided artificial insemination on pregnancy rates: a randomized study.

PURPOSE: To evaluate the influence of ultrasound guidance during intrauterine insemination (IUI) on pregnancy rates (PRs). The impacts of two different groups of providers were also investigated.

METHODS

Study population consisted of 387 gonadotropin stimulated IUI cycles performed for unexplained infertility. The patients were randomized into two groups as ultrasound-guided IUI (n = 180) and classical IUI (n = 207). Pregnancy rates were compared. Two groups were further analyzed based on the experience of the provider (senior versus junior subgroups) who performed IUI.

RESULTS

Pregnancy rates were higher in the ultrasound-guided IUI group (17.2%) compared to the classical IUI (10.1 %) (p = 0.042). In further analysis based on the experience of the provider; in the classical IUI group, PRs were similar for both subgroups, however, in the ultrasound-guided group it was higher when IUI was performed by a senior physician (21.7 versus 9.2%, p = 0.033). Logistic regression revealed that the experience of the provider was the independent variable for improved PRs.

CONCLUSIONS

Ultrasound guidance improves PRs only when a senior provider performs the IUI procedure. It seems that the experience of the provider physician is one of the determinants of IUI success.