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BOOK TITLE: Principles and Practice of Assisted Reproductive Technology
This chapter seeks to familiarize the readers with intrauterine insemination (IUI). IUI is widely used with infertility diagnoses other than bilateral tubal obstruction, severe male infertility, and severe ovulation defects. Prior to using in vitro fertilization (IVF), IUI with clomiphene ovarian stimulation is relatively cheap and many couples will conceive and not require IVF. IUI in stimulated cycles was effective only in patients with more than 3 years duration of infertility, but is associated with a significant rate of higher-order multiple births. The good success rate recently associated with mild stimulated IUI cycles must be confirmed by large trials. Prevention of premature luteinizing hormone (LH) surges and luteal phase support do not appear major requirements in IUI cycles. Although IUI treatment is cheaper and less demanding on the patient, IVF is the most effective treatment for infertility. There is a need for management trials to evaluate the order of treatment and overall effectiveness of treatment strategies in more clinical and cost settings.