Vaginal misoprostol enhances intrauterine insemination

• Published in: Human reproduction (Oxford) Vol. 16; no. 1; pp. 96 - 101
• Main Authors: Brown, Samuel E., Toner, James P., Schnorr, John A., Williams, Shaun C., Gibbons, William E., de Ziegler, Dominique, Oehninger, Sergio
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.01.2001
• Subjects: Administration, Intravaginal; Adult; Biological and medical sciences; Female; Genital system. Reproduction; Humans; Infertility - therapy; Insemination, Artificial, Heterologous; Insemination, Artificial, Homologous; intrauterine insemination; Male; Medical sciences; misoprostol; Misoprostol - administration & dosage; Pharmacology. Drug treatments; Pregnancy; Pregnancy Outcome; prostaglandin; vaginal; intrauterine insemination; prostaglandin; vaginal; misoprostol; pregnancy; Human; Intravaginal administration; Toxicity; Arachidonic acid derivatives; Assisted procreation; Prostaglandin E1; Misoprostol; Pregnancy; Eicosanoid; Analog; Artificial insemination; Female; Prostaglandin derivatives
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/humrep/16.1.96

This study examined whether the prostaglandin E1 analogue misoprostol (400 μg), when placed vaginally at the time of intrauterine insemination (IUI) improves pregnancy rates. A prospective, placebo-controlled, randomized and double-blind study involving 274 women in 494 IUI cycles resulted in a total of 64 pregnancies (13% per cycle). Misoprostol cycles totalled 253, with 43 pregnancies (17% per cycle), whereas placebo cycles totalled 241, with 21 pregnancies (9% per cycle). The cumulative pregnancy rate with misoprostol treatment was significantly greater than with placebo (P = 0.004, Cox proportional hazards regression). The benefit of misoprostol was seen in clomiphene cycles (14 versus 4%, P = 0.006), and was indicated in FSH cycles (33 versus 15%, borderline significance) and natural cycles (15.6 versus 7.7%, not significant), but was not seen in clomiphene/FSH cycles (18.2 versus 23.5%, not significant). Misoprostol treatment did not increase pain score on the day of IUI (1.1 versus 1.4) and at 1 day post IUI (0.6 versus 0.8). Complications were rare in both groups [six (2%) subject cycles in the misoprostol cycles compared with two (1%) in the placebo group]. It is concluded that the use of vaginal misoprostol may improve the chance for pregnancy in women having IUI in a wide variety of cycle types.