# Rescue intrauterine insemination in women failing to retrieve oocytes at ovum pick-up: report of a case series

## TL;DR

This study examines the use of rescue intrauterine insemination (IUI) for women who fail to retrieve oocytes during IVF, finding it to be a low-risk option with limited success.

## Contribution

The paper presents a case series evaluating the feasibility and outcomes of rescue IUI in selected patients with no retrieved oocytes.

## Key findings

- Rescue IUI was performed in 2.7% of oocyte retrievals with a 6.2% live birth rate.
- All pregnancies from rescue IUI were singletons.
- The procedure is simple and low-risk but has limited efficacy and generalizability.

## Abstract

Failure to collect oocytes at the time of oocyte pick-up is an unfavorable outcome of in vitro fertilization (IVF) cycles. In these cases, prompt intrauterine insemination (IUI) could be an option (rescue IUI), but this possibility has been poorly studied.

Rescue IUI is routinely offered in our unit in women failing to retrieve oocytes, provided that they have at least one patent tube, normal male semen analysis, and the total number of developed follicles is ≤ 3. We therefore reviewed all oocyte retrievals performed from 2006 to 2022 in our unit to identify these cases. As a comparator, we referred to preplanned IUI performed during the same study period. The 95% confidence interval (95% CI) of proportions was calculated using a binomial distribution model.

Rescue IUI was performed in 96 out of 3531 oocyte retrievals (2.7%; 95% CI 2.2–3.3%). Six live births were obtained, corresponding to 6.2% (95% CI 2.3–13.1). All pregnancies were singletons.

Rescue IUI in women failing to retrieve oocytes is a possible option that may be considered in selected cases. The efficacy is low, but the procedure is simple, and without significant risks. Generalizability to a conventional IVF protocol setting is however limited.