The empiric use of gonadotropin therapy and intrauterine insemination

Article Abstract:

The widespread use of gonadotropin therapy and intrauterine insemination may be based on experience rather than on scientific data. Gonadotropin-intrauterine insemination (GON-IUI) therapy may be most successful for couples with ovulatory dysfunction, unexplained infertility, endometriosis with no anatomic distortion, and cervical factor infertility when fallopian tubes are known to be open. Patients should have tried to become pregnant for at least one or two years before undergoing GON-IUI. Follicle-stimulating hormone may be more effective than human menopausal gonadotropin for most patients. Clomiphene citrate may not be a useful addition to gonadotropin induction in GON-IUI. Routine use of gonadotropin-releasing hormone (GnRH) analogs in GON-IUI cycles may vary among physicians. One IUI per cycle of GON-IUI may be sufficient to achieve pregnancy. Luteal phase support for patients undergoing GON-IUI therapy may not be necessary.

Health aspects, Panel Discussion, Gonadotropin, Gonadotropins

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Micromanipulative and conventional insemination strategies for assisted reproductive technology

Article Abstract:

Micromanipulative strategies for assisted reproductive technology (ART), including subzonal insemination and direct intracytoplasmic sperm injection (DICSI), may be used when standard in vitro fertilization (IVF) has failed. The two types of patients that may have the greatest risk of fertilization failure are those with severe male factor infertility and those whose in vitro fertilization attempts have failed before. Micromanipulation may be most useful when assisted fertilization is a last resort. Subzonal insemination may yield fairly good results, but direct intracytoplasmic sperm injection using single sperm may be better, although more invasive. Less invasive techniques of retrieving sperm from men with very low levels of sperm may be combined with DICSI technology and enable more couples to benefit from IVF in the future.

Human embryo, Human embryo transplantation

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In vitro fertilization, gamete intrafallopian transfer, and superovulation with intrauterine insemination: efficacy and potential health hazards on babies delivered

Article Abstract:

Less invasive and less costly infertility services may be used more often as initial infertility treatments. Researchers reviewed scientific articles discussing assisted conception to analyze the effectiveness and the risks associated with various methods. Superovulation treatments with uterine insemination for four menstrual cycles may be a less expensive and better choice for initial infertility treatment. Gamete intrafallopian transfer (GIFT) had a pregnancy per cycle rate of 29.5%, while the rate for in vitro fertilization (IVF) was just 19.8%. GIFT also had a higher delivery per cycle rate than IVF. Risks of treatments include ectopic pregnancy and multiple births from IVF and GIFT, and preterm labor and low birth weight even for single births.

Infertility, Female, Female infertility, Gamete intrafallopian transfer

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