Objectives: Our objective was to evaluate the effect of natural source of Prostaglandin in seminal fluid through natural
intercourse versus synthetic Prostaglandin (Misoprostol 400 Jlg) Vaginal tablets on the outcome of intra-uterine
insemination (lUI) when used 24 hours folJowing insemination.
Design: A prospective randomized control1ed study.
Setting: This study was carried out at Al-Azhar ART uint in IICPSR and Kamal Shacir IVF center along a period
started November 2001 to July 2004.
Patients & methods: Eighty six women complaining of primay infertility, their age ranged between 25 and 35 years
and BMI less than 28 kg/m? undergoing intrauterine Insemination due to male subfertility, were recruited to the study.
They were randomly allocated into three groups according to the adjunctive method used for them: Group I: 28
patients exposed to a single insemination set (control), Group-If 31 patients exposed to a single insemination set as
well as applying an intravaginal misoprostol (400 ug) tablet 12 hours later and Group-III: 27 patients exposed to a
single insemination set and instructed to do natural intercourse 12 hours later. All patients were subjected to controlled
ovarian hyper stimulation (COH) using clomiphene citrate 100 mg/day on days 3-7 and hMG 75 mIU 1M daily
injection from day 6 until the day of hCG. Then lUI was done 36 to 40 hours from hCG 1M injection (10.000 lU) and
luteal phase support until quantitative ~-hCG test.
Results: According to the outcome in this study, the pregnancy rate per patient was 10.7%, 19.3% and 14,8% in the
three groups respectively. The pregnancy rate per cycle was 3.6%, 6.8% and 5.2% in the studied groups respectivley.
Conclusion : Prostaglandin has an active role in improving the pregnancy rate in lUI treated cycles whatever its source
used (seminal or synthetic) as an adjunctive support. This could be either through improving uterine contractiltiy and
tubal peristaltic movement during sperm migration or by improving the endometrial receptivity.