Who is preferred to-Do Intra Uterine Insemination? Physician or Midwife

Background: Controlled ovarian hyper stimulation COH/IUI represents a therapy applicable to a wide variety of infertility diagnosis with no significant mechanical distortion of pelvic viscera. Identified variables influenced in Intra Uterine Insemination include: age, cause of infertility, sperm number, motility and normal percentage, use of gonadotropine and number of attempts at IUI. The role of provider on pregnancy outcome in IUI is unclear, and published data are rare. We compared pregnancy rate of result of IUI achieved by physicians and midwives in Hamadan Infertility Center. Methods: Data were prospectively collected from 89 IUI procedures with unexplained infertility and normal ovarian function, normal semen and normal pelvis at laparoscopy, which failed pregnant at least for 2 years. Controlled ovarian stimulation was performed by HMG on cycle day 3, and dosage varied according to the ovarian follicular response of patients by ultrasonography. Patients received 10/000 IU / IM HCG, when diameter of follicle reached >18mm. All patients received 50 mg / IM progesterone daily for 14 d. BHCG was tittered 15 d after IUI. Results: From 89 patients selected with unexplained infertility, IUI was done for 63 cases by trained midwives and for 26 cases by physicians. Mean age and duration of infertility in patients treated by physicians and midwives did not significantly different (27/3+5/32 to 25/5+4/2 y) and (5/16+3/6 y to 4/43+3/1 y) respectively. The pregnancy rate was 26/9% and 21/1%, respectively and there was not significant difference between two groups. Conclusion: we found no association between success rate and providers in IUI procedure, and pregnancy rate did not vary significantly between physicists and trained midwives in patients without cervical stenos.