IUI Risks

Ovarian Stimulation Drugs

The UK's National Institute for Clinical Excellence (NICE) has issued guidelines relating to multiple pregnancies as they result from intrauterine insemination (IUI). The professionals from this Institute cited statistics from a United States study which showed that intrauterine insemination resulted in a 22% increase in twin births, a 4% increase in triplets, and a 3% increase in the number of quadruplets born to couples who undergo this procedure. These statistics related to the usual practice of accompanying intrauterine insemination with ovarian stimulation drugs to increase success rates.

NICE Guidelines

When no such stimulation therapies were administered, it was found that intrauterine insemination alone did not increase the chances for multiple births. Due to this observation, NICE issued guidelines in February 2004 on the topic of intrauterine insemination and multiple births. The guidelines state that when intrauterine insemination is used to overcome male fertility issues, ovarian stimulation should be avoided since this appears to be no more effective than unstimulated intrauterine insemination. In addition, ovarian stimulation poses the risk of multiple pregnancy.

However, when intrauterine insemination is used as a therapy for unexplained fertility issues, both stimulated and unstimulated intrauterine insemination is more effective than no treatment at all. Still, the NICE guidelines state that ovarian stimulation should still be avoided, even though it can improve pregnancy rates, because of the risks of multiple pregnancy. Instead, NICE believes that a double course of insemination should be offered to bolster the couple's chances of conceiving a child.

It can be hard to balance the risk of multiple pregnancy against a possible negative outcome. Still, it's in a couple's best interests to educate themselves about the risks associated with this type of procedure. Couples should ask their doctors about the exact nature of the risks associated with multiple pregnancy and multiple births. Some doctors will be able to offer you helpful pamphlets or other literature on the topic.

It should be made clear to couples that when intrauterine insemination is administered due to male fertility issues, ovarian stimulation is unnecessary and has the potential to cause harm to the mother and child. Mild cases of endometriosis do benefit from stimulated intrauterine insemination.

Often, multiple pregnancies occur as the result of ovarian hyperstimulation which is caused by ovarian stimulation drugs during intrauterine insemination. This is a controlled form of ovarian hyperstimulation, and an overlooked cause of twin births. 

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