Artificial insemination for oligospermia. A critical review

The study concerns the review of the literature concerning the effectiveness of artificial insemination in cases of oligospermia. Differences in AIH techniques, the lack of standardized methodology explain the wide range of discrepancies in the resulting pregnancy rates. Still, in the course of time, a few certainties have been acquired: - A detailed and thorough investigation of the female partner is mandatory. - The use of fresh ejaculates is today totally obsolete, even with the help of cups, intra-cervical or eventual intra-uterine insemination. - The standardization of seminal parameters still remains an unsolved problem. - At the present time, intrauterine insemination with capacitated sperm is the method of choice. Still a basic condition is mandatory: a minimum of 1 M motile capacitated spermatozoa is required. - Timing of insemination determined by the LH peak seems the most valuable procedure. - The overall benefit is low, ±5% conception rate per cycle, and short lived because of the strain involved in an optimalized procedure. - The policy to plan 3 to 6 AIH cycles before going over to an IVF procedure is the more debatable.