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Evidence summaries

Comparison of Intrauterine and Intracervical Insemination with Frozen Donor Sperm

Intra-uterine insemination increases live birth rates and pregnancy rates compared to cervical insemination in stimulated cycles using cryopreserved sperm for donor insemination. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 6 studies with a total of 708 subjects. Insemination of donor sperm is a fertility treatment for women who are unable to conceive with their partner or are single. All the included studies used cryopreserved sperm in stimulated cycles (gonadotrophin-stimulated cycles in 2 studies and clomiphene-stimulated cycles in 2 studies). Intra-uterine insemination after 6 cycles significantly improved live birth rates (OR 1.98, 95% CI 1.02 to 3.86) and pregnancy rates (OR 3.37, 95% CI 1.90 to 5.96) in comparison to cervical insemination. There was no statistically significant evidence of an effect on multiple pregnancies (OR 2.19, 95% CI 0.79 to 6.07) or miscarriages (RR 3.92, 95% CI 0.85 to 17.96).

A systematic review 2 including 7 studies with a total of 444 subjects was abstracted in DARE. The pooled OR for success with intrauterine insemination was 2.4 (95% CI 1.5 to 3.8).

    References

    • Kop PA, Mochtar MH, O'Brien PA et al. Intrauterine insemination versus intracervical insemination in donor sperm treatment. Cochrane Database Syst Rev 2018;(1):CD000317. [PubMed]
    • Goldberg JM, Mascha E, Falcone T, Attaran M. Comparison of intrauterine and intracervical insemination with frozen donor sperm: a meta-analysis. Fertil Steril 1999 Nov;72(5):792-5. [PubMed][DARE]

Primary/Secondary Keywords