The successful use of hyperstimulated washed therapeutic donor insemination after standard therapeutic donor insemination has failed.

Objective: To investigate whether an aggressive therapeutic donor insemination regimen (stimulated folliculogenesis and ovulation plus intrauterine insemination) can produce a better fecundability rate than a more traditional insemination regimen (non-stimulated folliculogenesis plus LH-timed intracervical insemination) in women who have failed to become pregnant during an initial series of six traditional insemination cycles.

Design: A retrospective comparison of fecundability rates was undertaken between women undergoing the traditional insemination protocol and those who voluntarily switched to ovarian hyperstimulation coupled with intrauterine insemination.

Participants: Eight-two women who failed to become pregnant during an initial series of six intracervical insemination cycles.

Results: Fecundability was 5.6% in cycles of continued urinary LH-timed intracervical insemination and 19.4% when the more aggressive regimen was applied. The difference in fecundability between protocols was significant (P < .005).

Conclusion: After an initial series of donor inseminations has failed, a more aggressive insemination regimen involving ovarian hyperstimulation followed by washed intrauterine insemination provides a higher fecundability rate than continued intracervical insemination.