Strengths and Limitations:
The current study had several strengths, the foremost of which was its
large cohort size. To the best of our knowledge, ours is the
largest-to-date study comparing the two major IUI timing methods for
natural cycle IUI. Moreover, our study monitored the live birth rate of
natural cycle IUI, data which has been reported rarely in previous
studies.
Limitations of our study include the use of urinary LH monitoring, which
has been associated with increased probability for false-negative
results; such results would cause inaccurate timing and thereby likely
contribute to decreased pregnancy rates 3. However,
considering its advantages over alternatives (like serum LH testing)
such as ease-of-use, non-invasiveness, and low cost, urinary LH
monitoring is widely used in the clinic 26, 27. It
also bears mention that our clinical pregnancy rate in the spontaneous
LH group was 22.73%, a rate comparable to previously published natural
cycle IUI success rates. Second, our study is based on a retrospective
design. The inclusion criteria were strict, with only normo-ovulatory
women aged ≤ 35 years who underwent IUI with high-quality donor sperm
included, which enabled analysis of a well-defined cohort of women with
no obvious confounding factors.
Conclusion :
In conclusion, the administration of hCG for triggering of ovulation is
associated with significantly higher pregnancy rates compared with
spontaneous ovulation in patients undergoing natural IUI. Thus, using
hCG for timing ovulation optimizes the chances of success for natural
cycle IUI with donor sperm.