Pregnancy Success Rate in Timed Intercourse and IUI in Patients with Hypothalamic Amenorrhea

Background: Hypothalamic amenorrhea is one of the most prevalent problems leading to anovulation in which decrease in pulsatile release of GnRH is seen. Patients affected with hypothalamic amenorrhea who want to become pregnant must be induced by exogenous gonadotropin or GnRH to ovulate. Most patients consider this method inappropriate because they are forced to carry the mini-pump with them even while they are sleeping. The GnRH pump is not available in Iran. For this reason, exogenous gonadotropin is used then timed Intercourse (TI) or Intrauterine Insemination (IUI) are recommended to the patients for induction of ovulation. Otherwise, in Vitro Fertilization (IVF) or even Intracytoplasmic Sperm Injection (ICSI) techniques are used. TI is an easier and cheaper method compared to IVF and IUI. The objective of this study is to compare the pregnancy success rate of the two methods of TI and IUI. Methods: In this clinically relrospective study, hypothalamic amenorrhea patients who referred to infertility clinics of Reproductive Health Research Center, Tehran, Iran and registered between April 1999 to March 2005 were considered. TI or IUI, after induction of ovulation was administered and the rate of successful pregnancies was compared. The cases with infertility due to the male factor, uterine anomaly and fallopian tube obstruction were excluded. Results: In the TI group, from 27 cycles, there were 19 pregnancies (70.37%). In the IUI group, from 29 cycles, there were seven pregnancies (24.13%). The difference between these two methods was significant (P=0.05). Duration of infertility, mean age, and other demographic characteristic were not insignificant between the two groups. Conclusion: The results of this study provide support for TI as the first-line treatment for hypothalamic amenorrhea. Considering the ease, low cost, and lack of demand for equipment are some of adventages of this method.