ABSTRACT
In a therapeutic insemination cycle, although the number of available oocytes can be increased by ovarian stimulation, the results are still not very promising, mainly because of low sperm count, suboptimal spermatozoa or total absence of spermatozoa at the site of fertilization. Mortimer and Templeton1 showed that there is a reduction in sperm number of five to six orders of magnitude along the length of the female reproductive tract. After ejaculation, even when all semen characteristics were normal, there was still only a 49 percent chance of spermatozoa being found in the peritoneal cavity. However, significantly greater numbers of peritoneal spermatozoa have been found after artificial insemination into the external os, as compared to intercourse.1 Ripps et al2 showed that the number of spermatozoa recovered in the peritoneal fluid at laparoscopy after IUI was very low; however, the number increased after uterotubal flushes. Uterotubal flushes required a certain intrauterine perfusion pressure for the achievement of spill into normal tubes or in tubes with minimal adhesions.3
