[The study of the controlled ovarian stimulation and sperm capacitated AIH for the treatment of refractory infertility]

The clomiphene or hMG to stimulate ovarian follicle maturation which we call "controlled ovarian stimulation (COS)", in vitro capacitation (IVC) of spermatozoa and artificial insemination of husband's sperm (AIH) were simultaneously given to refractory infertile couples. The following couples were studied in 5 groups, 1 male subfertility 27 cases, 2 functional infertility 25 cases, 3 ovulatory dysfunction due to central mechanism 8 cases, 4 cervical mucous insufficiency 3 cases, 5 endometriosis 6 cases. The pregnancy rate was 21.7% in total (15 of 69 cases): 25.9% in group 1, 16.0% in group 2, 25.0% in group 3, 33.3% in group 4 and 16.7% in group 5. The follicle size and serum estradiol were measured every day during the periovulatory phase to evaluate follicle maturation. The Percoll centrifugation method was compared with the washing-centrifugation method with respect to the recovery rate and the concentration rate of motile spermatozoa. The recovery rate was 67.9% with the Percoll centrifugation method, and 40.0% with the washing-centrifugation method. The concentration rate was 1.81 times in the Percoll centrifugation method, and 1.19 times in the washing-centrifugation method. The present studies indicated that the combination of COS and IVC methods for AIH in refractory infertile couples was very effective.