“Controlled ovarian hyperstimulation” (COH) is the term used when we administer ovulation inducing medications to women who may or may not ovulate on their own. The purpose here is to obtain multiple egg release. COH/IUI refers to the combination of COH and intrauterine insemination. By increasing both the number of eggs and the number of sperm available, we hope to improve the probability that at least one viable pregnancy will result. COH/IUI is a commonly utilized infertility treatment because it can be useful in a variety of circumstances. But, since we still depend on the tubes to transport the egg and the uterus to promote implantation, this technique is best used in patients with a normal uterine cavity and normal fallopian tubes. Since this treatment is less expensive and more likely to be covered by insurance, we often try COH/IUI before moving to IVF.

Importantly, the combination of COH and IUI are more successful than either COH or IUI alone. Consequently, when we consider using one of these treatments, we usually consider using the combination. For this treatment to be effective, we try to produce 3-4 mature follicles through COH. Too many follicles increases the risk of multiple pregnancy while too few lowers the likelihood of success. Careful monitoring of the stimulation produces the greatest success. While clomiphene can be used, the highest success rates come from gonadotropin COH. Even with a fairly good prognosis for success, not all patients will conceive promptly. We recommend at least 3 cycles but no more than 6 before moving on to other treatment options.