Does IUI technique matter?

When sperm wash techniques were first developed with a medium called Ham’s F10 artifical insemination was revolutionized. Prior to that time all that was available was cup insemination (ICI) or injection into the cervical mucus which itself was often the problem. Over the years culture media has vastly improved but the technique of actually performing the procedure was relatively standard and REs generally use the technique they learned from their mentors in training which does not vary much from doctor to doctor.

Now apparently the big question is whether or not to clean away the cervical mucus before performing an IUI. And of course there is no a study. Cervical mucus removal before intrauterine insemination (IUI) can improve pregnancy outcomes in women with unexplained infertility, according to a study published online. As reported by Health Day News, Mohammad Ahmed Maher, M.D., from Menoufia University in Shibin El-Kom, Egypt, and colleagues randomly assigned patients undergoing IUI for unexplained infertility to either mucus removal (361 participants) or no mucus removal (353 participants).

The researchers found that, compared to the no mucus removal group, the clinical pregnancy rate was significantly higher in the mucus removal group (31.0 versus 21.8 percent). Ovarian hyperstimulation developed in 33 cases (18 in the cervical mucus removal group and 15 in the no mucus removal group). All of these cases, except for one, were mild and managed as outpatient care and this complication is in no way related to the cervical mucus issue.

“Our results showed that cervical mucus removal prior to IUI can enhance pregnancy outcomes in women with unexplained infertility but these results should also be confirmed by more randomized trials as the availability of only few studies indicates a true gap in the evidence of the procedure in the literature,” the authors write.

I have always been a “mucus wiper” because it is not necessary for success, makes the procedure more sanitary and the mucus may contain antibodies to sperm and although we are depositing the sperm above the mucus it could potentially have an effect on the outcome.

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