Effect of Vaginal Misoprostol on Success Rate of Intrauterine Insemination

Intrauterine insemination has an important role in the treatment of infertile couples. Usage of vaginal misoprostol therapy at the time of intrauterine insemination was investigated and its tolerability and effects on clinical pregnancy rates was assessed. The objective was to assess the effectiveness of misoprostol after intrauterine insemination on pregnancy success in infertile female, and investigate if misoprostol effect on pregnancy before intrauterine insemination. Eighty-one infertile couples who attended the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, and private fertility clinics were enrolled in this study. The period of collection of patients extended from September (2018) until May (2019). Patients were divided into two groups, first group received 100-µg vaginal misoprostol immediately after completion of intrauterine insemination procedure while control group were subjected to ordinary intrauterine insemination procedure without adjunctive therapy. There was no significant effect of active motility, the percentage of pregnancy rate in control group was 5.0% while it was 19.5% in Misoprostol post IUI. Moreover, there is a significant difference in pregnancy rate among all study groups. However, there is no significant result of pregnancy outcome related with sperm parameter before and after activation of semen sample. Misoprostol use after intrauterine insemination has positive impact on pregnancy outcome. Smaller doses of misoprostol can decrease side effects without affecting the outcome. No significant difference in pregnancy rate was noted between pregnancy outcome with mild to moderate oligozoospermia, asthenozoospermia and normozoospermia men which may be attributed to good preparation of semen samples for intrauterine insemination.