How successful is intrauterine insemination in women with endometriosis?

23 Sep How successful is intrauterine insemination in women with endometriosis?

By I. Soussis MD

How successful is intrauterine insemination in infertile women with endometriosis?

Tummon et al. 1997 enrolled 103 infertile couples with endometriosis stage I and II in a prospective randomized  study. Of those patients 53 underwent superovulation treatment with gonadotrophins and intrauterine insemination (127 cycles) and  the remaining 50 were the control group and were just observed for 184 cycles. The birth rate in the treatment group were 5-6 higher than the controls.

Cumulative pregnancy rate.
Women with IUI and superovulation versus no treatment

In another study, initially randomized, Nulsen et al. 1993, compared superovulation with gonadotrophins and intrauterine insemination with insemination without superovulation.

The success rate was 5.7 times higher in the superovulation group.

Werbrouck et al. 2006, studied infertile women with endometriosis, who were treated with gonadotrophins and intrauterine insemination within six months from their laparoscopy. They reported pregnancy rates similar to those with unexplained infertility (20% vs 20,5%).

ESHRE Guidelines 2015:

1. Superovulation with gonadotrophins and intrauterine insemination in infertile women with endometriosis stage I and II increases the birth rate compared with conservative management (observation).

2. Superovulation with gonadotrophins and intrauterine insemination in infertile women with endometriosis stage I and II increases the birth rate compared with intrauterine insemination alone.

3. Superovulation with gonadotrophins and intrauterine insemination in infertile women with endometriosis, within six months of laparoscopy, is equally effective as in those with unexplained infertility.

Good Practice Point (opinion of the ESHRE specialists). IVF treatment is advised if there is tubal factor, sperm problems or other treatment have failed.