Published 29 October 2009, doi:10.1136/bmj.b4080
Cite this as: BMJ 2009;339:b4080

Research

Immobilisation versus immediate mobilisation after intrauterine insemination: randomised controlled trial

¹ Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands, ² Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, ³ Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands, ⁴ Department of Obstetrics and Gynaecology, Antonius Ziekenhuis, Nieuwegein, Netherlands, ⁵ Department of Obstetrics and Gynaecology, TweeSteden Ziekenhuis, Tilburg, Netherlands, ⁶ Department of Obstetrics and Gynaecology, Martini Ziekenhuis, Groningen, Netherlands, ⁷ Department of Obstetrics and Gynaecology, Groene Hart Ziekenhuis, Gouda, Netherlands

Objective To evaluate the effectiveness of 15 minutes of immobilisation versus immediate mobilisation after intrauterine insemination.

Design Randomised controlled trial.

Setting One academic teaching hospital and six non-academic teaching hospitals.

Participants Women having intrauterine insemination for unexplained, cervical factor, or male subfertility.

Interventions 15 minutes of immobilisation or immediate mobilisation after insemination.

Main outcome measure Ongoing pregnancy per couple.

Results 391 couples were randomised; 199 couples were allocated to 15 minutes of immobilisation after intrauterine insemination, and 192 couples were allocated to immediate mobilisation (control). The ongoing pregnancy rate per couple was significantly higher in the immobilisation group than in the control group: 27% (n=54) versus 18% (34); relative risk 1.5, 95% confidence interval 1.1 to 2.2 (crude difference in ongoing pregnancy rates: 9.4%, 1.2% to 17%). Live birth rates were 27% (53) in the immobilisation group and 17% (32) in the control group: relative risk 1.6, 1.1 to 2.4 (crude difference for live birth rates: 10%, 1.8% to 18%). In the immobilisation group, the ongoing pregnancy rates in the first, second, and third treatment cycles were 10%, 10%, and 7%. The corresponding rates in the mobilisation group were 7%, 5%, and 5%.

Conclusion In treatment with intrauterine insemination, 15 minutes’ immobilisation after insemination is an effective modification. Immobilisation for 15 minutes should be offered to all women treated with intrauterine insemination.

Trial registration Current Controlled Trials ISRCTN53294431 [controlled-trials.com] .

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

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