Does intrauterine insemination offer an advantage to cervical cap insemination in a donor insemination program?

Objective: To compare pregnancy outcome after IUI versus cervical cap insemination in a donor insemination program. Design: A randomized prospective clinical trial in which patients were alternately inseminated with cryopreserved human semen using either IUI or cervical cap insemination methods. Setting: The donor insemination program at Washington University School of Medicine. Patients: Forty-two women with either isolated male factor or male factor plus corrected ovulatory dysfunction using clomiphene citrate underwent 141 cycles of donor insemination. Main Outcome Measures: Clinical pregnancy rates (PRs) defined as a viable intrauterine gestation > 12 weeks or delivered were compared between groups using the X² test. Results: Clinical PRs were significantly higher in the IUI group (16.4%) compared with the cervical cap insemination group (5.9%). The spontaneous abortion rates were similar between the IUI (1.4%) and cervical cap insemination groups (4.4%). Conclusions: These findings suggest an advantage to IUI over cervical cap insemination in a donor insemination program.