Strengths and Limitations:
The current study had several strengths, the foremost of which was its large cohort size. To the best of our knowledge, ours is the largest-to-date study comparing the two major IUI timing methods for natural cycle IUI. Moreover, our study monitored the live birth rate of natural cycle IUI, data which has been reported rarely in previous studies.
Limitations of our study include the use of urinary LH monitoring, which has been associated with increased probability for false-negative results; such results would cause inaccurate timing and thereby likely contribute to decreased pregnancy rates 3. However, considering its advantages over alternatives (like serum LH testing) such as ease-of-use, non-invasiveness, and low cost, urinary LH monitoring is widely used in the clinic 26, 27. It also bears mention that our clinical pregnancy rate in the spontaneous LH group was 22.73%, a rate comparable to previously published natural cycle IUI success rates. Second, our study is based on a retrospective design. The inclusion criteria were strict, with only normo-ovulatory women aged ≤ 35 years who underwent IUI with high-quality donor sperm included, which enabled analysis of a well-defined cohort of women with no obvious confounding factors.
Conclusion :
In conclusion, the administration of hCG for triggering of ovulation is associated with significantly higher pregnancy rates compared with spontaneous ovulation in patients undergoing natural IUI. Thus, using hCG for timing ovulation optimizes the chances of success for natural cycle IUI with donor sperm.