Simultaneous Administration of Human Chorionic Gonadotropin for Intrauterine Insemination Improves Pregnancy Rate in Stimulated Cycles: A Randomized Controlled Trial

Abstract

Background: Intrauterine insemination (IUI) is among the most common methods for individuals with infertility. Objectives: This study aims to assess the pregnancy rates (laboratory and clinically) following simultaneous IUI with human chorionic gonadotropin (hCG) triggering and those performed 36-40 hours following the hCG triggering. Methods: In this open-label randomized controlled trial, a total of 248 couples were randomly (1:1 ratio) assigned to either the intervention (challenging method) or control (conventional method) group. Laboratory- and clinically-confirmed pregnancy were considered the main outcome. This study used intention-to-treat analysis, and any P-value less than 0.05 was considered statistically significant. Results: Total numbers of laboratory- and clinically-confirmed pregnancies, which were the same in each arm (N = 124), were significantly higher (P-value = 0.038) in the intervention group (N = 31; 25.00%) compared to the controls (N = 18; 14.52%). Moreover, to address the effect of covariates, especially those with chance imbalance (sperm count and morphology), multivariable logistic regression models were performed with and without the allocated treatment group. Following this, the models revealed that no covariate, except the allocated treatment, had a statistically significant effect (OR = 2.22, 95% CI: 1.09 to 4.53) on the outcome. Conclusions: According to the results, it seems that simultaneous hCG triggering with IUI could improve the pregnancy rate; however, further pragmatic trials are required.