Clin Exp Reprod Med.  2019 Jun;46(2):87-94. 10.5653/cerm.2019.46.2.87.

Ultrasound guidance versus the blind method for intrauterine catheter insemination: A randomized controlled trial

Affiliations
  • 1Reproductive Medicine Unit, Department of Obstetrics and Gynaecology, General Hospital Kuala Lumpur, Kuala Lumpur, Malaysia. sarahmubarak@yahoo.com
  • 2National Clinical Research Centre, General Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.

Abstract


OBJECTIVE
The primary objective of this study was to compare clinical pregnancy rates in intrauterine insemination (IUI) treatment cycles with transabdominal ultrasound guidance during intrauterine catheter insemination (US-IUI) versus the "blind method" IUI without ultrasound guidance (BM-IUI). The secondary objective was to compare whether US-IUI had better patient tolerability and whether US-IUI made the insemination procedure easier for the clinician to perform compared to BM-IUI.
METHODS
This was a randomized controlled trial done at the Reproductive Medicine Unit of General Hospital Kuala Lumpur, Malaysia. We included women aged between 25 and 40 years who underwent an IUI treatment cycle with follicle-stimulating hormone injections for controlled ovarian stimulation.
RESULTS
A total of 130 patients were recruited for our study. The US-IUI group had 70 patients and the BM-IUI group had 60 patients. The clinical pregnancy rate was 10% in both groups (p> 0.995) and there were no significant difference between the groups for patient tolerability assessed by scores on a pain visual analog scale (p= 0.175) or level of difficulty for the clinician (p> 0.995). The multivariate analysis further showed no significant increase in the clinical pregnancy rate (adjusted odds ratio, 1.07; 95% confidence interval, 0.85-1.34; p= 0.558) in the US-IUI group compared to the BM-IUI group even after adjusting for potential covariates.
CONCLUSION
The conventional blind method for intrauterine catheter insemination is recommended for patients undergoing IUI treatment. The use of ultrasound during the insemination procedure increased the need for trained personnel to perform ultrasonography and increased the cost, but added no extra benefits for patients or clinicians.

Keyword

Artificial insemination; Insemination; Pregnancy rates; Ultrasound; Visual analog pain scale

MeSH Terms

Catheters*
Female
Follicle Stimulating Hormone
Hospitals, General
Humans
Insemination*
Insemination, Artificial
Malaysia
Methods*
Multivariate Analysis
Odds Ratio
Ovulation Induction
Pain Measurement
Pregnancy Rate
Reproductive Medicine
Ultrasonography*
Visual Analog Scale
Follicle Stimulating Hormone
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