Single or double intrauterine insemination (IUI) for infertile couples: Does double IUI increases the rate of clinical pregnancy?

INTRODUCTION: In this pilot study, it was aimed to demonstrate the efficacy of double intrauterine insemination (IUI) in the controlled ovarian hyperstimulation (COH) cycles with multiple follicular development.
METHODS: Thirty-eight patients involved in IUI program, aged 20-35 years, underwent human chorionic gonadotropin (hCG) procedure in assisted reproductive techniques (ART), between March 2017 and March 2018, in the Gynecology and Obstetrics Clinics of a tertiary center. Thereafter, double IUI was performed at 18th and 36th hours; thirty-two patients, aged 22-35 years, received hCG, and a single IUI was performed at the 36th hour. Demographic characteristics of 70 patients were recorded from the hospital records; age, weight, height, previous history of pregnancy (gravida, parity), smoking habits, hormonal levels at the 3rd day of their menstrual cycle [follicle stimulating hormone (FSH), Luteinizing Hormone (LH), Estradiol (E2)], prolactin, anti-Mullerian hormone (AMH), antral follicle count (AFC), type and duration of infertility.
RESULTS: A total of 70 infertile patients were included in the study between April 2017 and May 2018. Of those, 32 (45.7%) were in the single IUI group and 38 (54.2%) were in the double IUI group. When the median values of the dominant follicle number> 15 mm on the HCG day of the women in the second group were examined, they were found as 2.0 (1-3) and 2.0 (1.0-3.0) in the study and control group, respectively (p = 0.139).When the clinical pregnancy rates (%) of the women in the two groups were examined, they were found as 21.05% and 18.75% in the study and control group, respectively (p = 0.812).
DISCUSSION AND CONCLUSION: In the present study, it was observed that there was no significant difference between the clinical pregnancy rates of single and double IUI procedure during intrauterine insemination after ovulation induction with COH. Therefore, by considering the treatment costs, it is necessary to share the results with the patient in the cases of intrauterine insemination.