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• W3021718897 abstract "We appreciate Dr. Meldrum's interest in our article comparing the effectiveness of single IUI versus double IUI per cycle in infertile patients (1Alborzi S. Motazedian S. Parsanezhad M.E. Jannati S. Comparison of the effectiveness of single intrauterine insemination (IUI) versus double IUI per cycle in infertile patients.Fertil Steril. 2003; 80: 595-599Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar).Of note, our null hypothesis was that the success rate would differ if double IUI was performed instead of single IUI. Considering this issue, we again analyzed our data for the first two cycles of our patients. The power of the study was calculated to be around 90%.As Dr. Meldrum stated, there are two positive studies in the literature on this subject (2Silverberg K.M. Johnson J.V. Olive D.L. Burns W.N. Schenken R.S. A prospective, randomized trial comparing two different intrauterine insemination regimens in controlled ovarian hyperstimulation cycles.Fertil Steril. 1992; 57: 357-361Abstract Full Text PDF PubMed Google Scholar, 3Ragni G. Maggioni P. Guermandi E. Testa A. Baroni E. Colombo M. et al.Efficacy of double intrauterine insemination in controlled ovarian hyperstimulation cycles.Fertil Steril. 1999; 72: 619-622Abstract Full Text Full Text PDF PubMed Scopus (74) Google Scholar). The number of the patients enrolled in one study (2Silverberg K.M. Johnson J.V. Olive D.L. Burns W.N. Schenken R.S. A prospective, randomized trial comparing two different intrauterine insemination regimens in controlled ovarian hyperstimulation cycles.Fertil Steril. 1992; 57: 357-361Abstract Full Text PDF PubMed Google Scholar) was low; extending the study might have equalized the group cycle fecundities. The other study included a relatively large number of patients who were divided in three groups, each of which had a different insemination time (3Ragni G. Maggioni P. Guermandi E. Testa A. Baroni E. Colombo M. et al.Efficacy of double intrauterine insemination in controlled ovarian hyperstimulation cycles.Fertil Steril. 1999; 72: 619-622Abstract Full Text Full Text PDF PubMed Scopus (74) Google Scholar). One may assume that other variables exist that may influence the results when single IUI was performed for one group and double IUI for another one. We used consecutive cycles in which each patient acted as her control, in an effort to decrease bias.The pregnancy rates per cycle in single IUI and double IUI in the negative study were 11% and 14%, respectively, and did not reach statistical significance (4Ransom M.X. Blotner M.B. Bohrer M. Corsan G. Kemmann E. Does increasing frequency of intrauterine insemination improve pregnancy rates significantly during superovulation cycles?.Fertil Steril. 1994; 61: 303-307PubMed Scopus (48) Google Scholar). Our pregnancy rate per cycle does not differ greatly from those of other studies. Another recent study in the literature reported a similar result (5Hamilton J. Latarche E. Gillott C. Lower A. Grudzinskas J.G. Intrauterine insemination results are not affected if hysterosalpingo contrast sonography is used as the sole test of tubal patency.Fertil Steril. 2003; 80: 165-171Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar).We agree with Dr. Meldrum that a large study is still needed. We appreciate Dr. Meldrum's interest in our article comparing the effectiveness of single IUI versus double IUI per cycle in infertile patients (1Alborzi S. Motazedian S. Parsanezhad M.E. Jannati S. Comparison of the effectiveness of single intrauterine insemination (IUI) versus double IUI per cycle in infertile patients.Fertil Steril. 2003; 80: 595-599Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar). Of note, our null hypothesis was that the success rate would differ if double IUI was performed instead of single IUI. Considering this issue, we again analyzed our data for the first two cycles of our patients. The power of the study was calculated to be around 90%. As Dr. Meldrum stated, there are two positive studies in the literature on this subject (2Silverberg K.M. Johnson J.V. Olive D.L. Burns W.N. Schenken R.S. A prospective, randomized trial comparing two different intrauterine insemination regimens in controlled ovarian hyperstimulation cycles.Fertil Steril. 1992; 57: 357-361Abstract Full Text PDF PubMed Google Scholar, 3Ragni G. Maggioni P. Guermandi E. Testa A. Baroni E. Colombo M. et al.Efficacy of double intrauterine insemination in controlled ovarian hyperstimulation cycles.Fertil Steril. 1999; 72: 619-622Abstract Full Text Full Text PDF PubMed Scopus (74) Google Scholar). The number of the patients enrolled in one study (2Silverberg K.M. Johnson J.V. Olive D.L. Burns W.N. Schenken R.S. A prospective, randomized trial comparing two different intrauterine insemination regimens in controlled ovarian hyperstimulation cycles.Fertil Steril. 1992; 57: 357-361Abstract Full Text PDF PubMed Google Scholar) was low; extending the study might have equalized the group cycle fecundities. The other study included a relatively large number of patients who were divided in three groups, each of which had a different insemination time (3Ragni G. Maggioni P. Guermandi E. Testa A. Baroni E. Colombo M. et al.Efficacy of double intrauterine insemination in controlled ovarian hyperstimulation cycles.Fertil Steril. 1999; 72: 619-622Abstract Full Text Full Text PDF PubMed Scopus (74) Google Scholar). One may assume that other variables exist that may influence the results when single IUI was performed for one group and double IUI for another one. We used consecutive cycles in which each patient acted as her control, in an effort to decrease bias. The pregnancy rates per cycle in single IUI and double IUI in the negative study were 11% and 14%, respectively, and did not reach statistical significance (4Ransom M.X. Blotner M.B. Bohrer M. Corsan G. Kemmann E. Does increasing frequency of intrauterine insemination improve pregnancy rates significantly during superovulation cycles?.Fertil Steril. 1994; 61: 303-307PubMed Scopus (48) Google Scholar). Our pregnancy rate per cycle does not differ greatly from those of other studies. Another recent study in the literature reported a similar result (5Hamilton J. Latarche E. Gillott C. Lower A. Grudzinskas J.G. Intrauterine insemination results are not affected if hysterosalpingo contrast sonography is used as the sole test of tubal patency.Fertil Steril. 2003; 80: 165-171Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar). We agree with Dr. Meldrum that a large study is still needed." @default.
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