Sperm preparation and in utero insemination in the management of subfertility.

OBJECTIVE: To study the place of sperm preparation and in utero insemination in subfertile couples in whom ovulatory and tubal aetiological factors have been excluded or treated. DESIGN: A retrospective cohort study. SETTING: Diagnostic Seminology Laboratory, Galle. SUBJECTS AND METHODS: Patients (n = 325) who had in utero insemination (IUI) from September 1990 to June 1994 were studied retrospectively. All had stimulation of ovaries with clomiphene and the Insler score was used to confirm ovulation before IUI. Swim up, spin down and glass wool filtration techniques, and the Earl's balanced salt solution with human serum albumin were used for sperm preparation. MAIN OUTCOME MEASURES: Association between variables. RESULTS: Of the subjects 97(30%) had male factor, 79(24%) abnormal sperm-cervical mucous interaction and 41(13%) idiopathic subfertility. In 114(35%) the cause was not documented. The number of IUI attempts per subject ranged from 1 to 19 with a mean of 4.2 and SD 3.2. There were no significant difference in conception rates in relation to the different methods of sperm preparation or the underlying aetiological factor. CONCLUSION: Sperm preparation and in utero insemination are feasible in Galle and should be considered as an option in the treatment of subfertility.