Thus, the authors analyzed the usefulness of IVI before applying ART and proposed the inclusion criteria of IVI as a treatment method for infertility. Our clinic, which is specialized in infertility management for more than 10 years, has helped many patients, including couples with sexual dysfunction. Pregnancy should be achieved without penile insertion into the vagina in an unconsummated marriage.Īlthough many studies regarding IVI on ejaculatory dysfunction have been reported, only a few studies on the effectiveness of IVI as an infertility treatment for couples with general sexual dysfunction, especially ED, are available. IVI may further be applied to treat couples with sexual dysfunction if semen can be obtained by the husband through masturbation. IVI can be performed personally at home in a private room, and does not impact marital activities. IVF and ICSI also involve burdensome processes such as ovarian stimulation by gonadotropins, frequent clinic visits to follow the follicle growth, and oocyte retrieval under anesthesia, In addition, IUI, IVF, and ICSI are all expensive with a cost of about 10 000-30 000, 200 000-500 000, and 300 000-600 000 yen, respectively, without national health insurance coverage in Japan.Ĭontrarily, intravaginal insemination (IVI) as an artificial home vaginal insemination is a simple, noninvasive, and inexpensive method, which does not require frequent doctor visits. 6 Although ART is very effective as an infertility treatment, IUI can be painful when a speculum is inserted into the vagina and further, women are required to visit the clinic repeatedly. 5 In vitro fertilization (IVF) and a microinsemination of intracytoplasmic sperm injection (ICSI) are further applied more than 465,000 babies were born in 2012 using these technologies throughout the world.
Intrauterine insemination (IUI) is widely used as the treatment method for mild male factor and unexplained infertilities. Conversely, assisted reproductive technology (ART) has made it possible to conceive without coitus. Moreover, without insertion of penis into the vagina and/or no ejection of semen in the vagina, the sperm cannot be inseminated into the woman's reproductive organ, which causes infertility. Epidemiological studies reveal that male sexual dysfunction has a prevalence of 5%-30%, 1- 3 which shows that sexual conditions present not only medical but also social problems. Male sexual dysfunction such as low libido, erectile dysfunction (ED), and premature or inhibited ejection, and female dysfunction such as inhibited sexual desire, inability to become aroused, anorgasmia, vaginismus, and dyspareunia, can result in unsatisfied sex or sexless situation. Sexual dysfunction is a serious problem resulting in both sexual and reproductive issues. Since IVI appears to be a simple, noninvasive, and inexpensive way for couples with sexual dysfunction, it can be attempted before ART application.
IVI FERTILITY COST TRIAL
The authors can propose the following inclusion IVI criteria for couples with sexual dysfunction: (a) younger husband (36 years old or less) which may be most important, (b) infertility duration of 3 years or less, (c) normal sperm condition, and (d) IVI trial for 3 times (maximum of 6 times).
Among the 57 successful cases who underwent IVI treatment, 38 (66.7%) patients became pregnant within 3 times of the procedure, while 48 (84.2%) patients conceived within 6 times. The husbands who could not impregnate had a significantly higher ratio of sperm abnormalities ( P = .0048). Between the pregnant and non-pregnant cases, the husband's age and infertility period were significantly higher ( P = .0104) and longer ( P = .0027) in the unsuccessful cases than the successful ones. Of 144 patients, 58 women conceived successfully (40.3% pregnancy rate). The profiles of pregnant and non-pregnant patients were compared. MethodsĪmong 208 couples who presented sexual dysfunction, 144 couples underwent IVI procedures.
To analyze the usefulness of intravaginal insemination (IVI) for the infertility treatment in couples with sexual dysfunction before applying assisted reproductive technology (ART).
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