Prospective randomized study for hydrotubation versus no hydrotubation before intrauterine insemination in unexplained infertility.

The purpose of the study was to investigate the value of hydrotubation before intrauterine insemination (IUI). In 228 patients with the diagnosis of unexplained infertility, ovarian stimulation was performed before IUI, using 100mg of clomiphine citrate for 5 days from day 3 of the cycle and one ampoule of human menopausal gonadotrophin for 5 days from day 6 of the cycle. Folliculometry and determination of LH concentration in urine were performed daily until LH became positive, then randomization for hydrotubation before IUI versus no hydrotubation was performed. Fifteen patients were cancelled from the study due to poor response or stimulation of three or more follicles. A total of 213 patients were randomized as follows: 103 patients undergoing hydrotubation using 50 ml of saline and 110 patients with no hydrotubation. IUI was performed the following day and ongoing pregnancy occurred in 13 patients (12.6%) in the hydrotubation group and nine patients (8.2%) in the non-hydrotubation group with no significant difference (OR 1.66; 95% CI 0.62-4.63). In conclusion, hydrotubation before IUI does not improve pregnancy rate.