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Minimal Endometriosis and Intrauterine Insemination: Does Controlled Ovarian Hyperstimulation Improve Pregnancy Rates?

From the Faulkner Centre for Reproductive Medicine, Faulkner Hospital, Deaconess/Harvard Surgical Program, Harvard Medical School, Boston, Massachusetts

Abstract

Fifty normally menstruating women staged laparoscopically as having minimal endometriosis were given an option to be treated with intrauterine insemination with or without ovarian stimulation. Twenty-rive patients had unmedicated natural cycles (ie, no medication for follicular stimulation), and 25 underwent controlled ovarian hyperstimulation. All subjects received hCG to time ovulation, followed 36 hours later with intrauterine insemination. Sixteen pregnancies, eight in each group, resulted from a total of 132 cycles. The cumulative probabilities of conception for the first, second, and third cycles were 0.13, 0.26, and 0.38 in the natural-cycles group and 0.12, 0.25, and 0.34 in the medicated-cycles group, respectively (P>.05). Monthly fecundity was 0.14 for the natural-cycles group and 0.13 for the medicated-cycles group (P>.05). We conclude that there is no difference in pregnancy rates or monthly fecundity over a 3-month period with controlled ovarian hyperstimulation as opposed to natural cycles combined with intrauterine insemination.