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J Obstet Gynaecol India. 2017 Apr;67(2):79-85. doi: 10.1007/s13224-016-0928-5. Epub 2016 Aug 22.

A New Dawn for Intrauterine Insemination: Efficient and Prudent Practice will Benefit Patients, the Fertility Industry and the Healthcare Bodies.

Journal of obstetrics and gynaecology of India

Gulam Bahadur, Roy Homburg, Ansam Al-Habib

Affiliations

  1. Reproductive Medicine Unit, North Middlesex University Hospital, Old Admin Block, Sterling Way, London, N18 1QX UK.
  2. Homerton Fertility Unit, Homerton University Hospital, Homerton Row, London, E9 6SR UK.
  3. Chelsea and Westminster NHS Foundation Trust/West Middlesex University Hospital, Twickenham Road, Isleworth, London, TW7 6AF UK.

PMID: 28405113 PMCID: PMC5371520 DOI: 10.1007/s13224-016-0928-5

Abstract

This review addresses the misplaced facts about the IUI procedure within a lucrative fertility industry. Evidence suggests IUI must be a first-line treatment option for most couples except in cases of bilateral tubal blockage and severe oligozoospermia. We introduce the concept of using 'consecutive ejaculation' in men with subfertility and one which can radically alter the male infertility definition, thereby providing a new approach to examining and managing male factor infertility. The review also explores various aspects affecting the IUI procedure, its determinants of success, risks and areas for future improvements. Areas such as choice of patients, clinical management of patients, the type of stimulation regime, timing and the management of sperm usage have significant bearing to whether IUI will succeed. The paper asserts that IUI should be the first choice of fertility treatment.

Keywords: Bifollicular; Clomiphene; Cost-effectiveness; Expectant management; GnRH; IUI; IVF; Male factor; Pregnancy rates; Unifollicular

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