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Cramping Doesn’t Hurt IUI Chances

It is rather common for women to experience mild to moderate cramping after intrauterine insemination (IUI). More information is coming forward to support the probability that cramping does not decrease the chances of pregnancy at all.

Based on an earlier study suggesting intravaginal prostaglandins were beneficial, a new study gave misoprostol to patients at the time of IUI.  Prostaglandins are a group of hormone-like fatty acids found in the body, especially semen, that affect essential body processes, including fertilization. Misoprostol is a synthetic prostaglandin that, among other things, causes cramping. The hypothesis of this new study was that vaginal supplementation of prostaglandins at the time of IUI may enhance the likelihood of conception.

A multi-center prospective, randomized, double-blind trial studied the effect of misoprostol on the outcome of intrauterine insemination. Researchers with the Department of Obstetrics and Gynaecology at Ghent University Hospital in Belgium used vaginal tablets of misoprostol or a placebo along with intrauterine insemination.  They analyzed 466 cycles, from 199 women, and measured pregnancy rate, uterine cramps, and vaginal bleeding.

Those given the placebo added up to 164 cycles and 21 pregnancies, while the others given misoprostol totaled 146 cycles with 19 pregnancies.  The 12.8% vs. 13% finding was not compelling.  However, there was a substantial increase in both abdominal cramping (15.1 vs. 4.3%; OR 3.98; 95% CI 1.68-9.39) and vaginal bleeding (12.3 vs. 1.8%; OR 7.55; 95% CI 2.31-24.48) in those treated with misoprostol.  These adverse effects led to the early termination of the study.

It’s essential to take note of the fact that there was no decrease in pregnancy rates, even with the introduction of significant cramping.  

Prostaglandins undoubtedly play a role in natural human reproduction, although vaginal administration of misoprostol at the time of IUI is associated with a high rate of side effects and has not been proven to enhance the outcome. 

As always, MCRM Fertility strives to keep you at the forefront of new information as it becomes available.  Our team is here to support you and answer any questions or concerns you may have. Please consider us your partner along your journey to fertility.