Intrauterine insemination (IUI) alone or with ovarian stimulation is used commonly to assist infertile couples. To determine whether women should remain supine after insemination, investigators at several assisted reproduction centers in the Netherlands randomized 391 women (age range, 18–43) to 15 minutes of immobilization or immediate mobilization for 3 IUI cycles. Before IUI, most women underwent controlled ovarian hyperstimulation with clomiphene citrate or recombinant follicle-stimulating hormone followed by human chorionic gonadotropin to induce ovulation. The remaining women underwent only IUI.

The ongoing pregnancy rate per couple was substantially higher in the immobilization group than in the control group (27% vs. 18%). Live birth rates also were significantly higher in the immobilization group (27% vs. 17%), and time to pregnancy was significantly shorter.

Comment: The authors suggest that immobilization in the supine position for 15 minutes following insemination in the lithotomy position should become standard procedure because of its simplicity. However, as an editorialist notes, we do not know if ovarian stimulation affected the findings. Moreover, pregnancy rates in both groups were lower than those reported by many centers that do not employ immobilization.

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