Studies on single insemination with donor's semen.
From 1956 to 1960 in the Planned Parenthood Consultation Clinic of Keio University, Japan, 108 successful pregnancies resulted from a single insemination with a donor's semen. Patient age averaged 29.5 years; average sterile period, 5.37 years. Most had regular menstruation. 12 had suffered from tuberculosis, 1 from nephritis, 1 from pyelitis, 2 cystitis, and 1 purpura. In 5 cases a suspension operation of the uterus had been done and in 11 appendectomies. Pelvic examination revealed hypoplasia of the uteri in 61 cases, extreme in 6. There was displacement of the uterus in 51 cases. Hysterosalpingography showed unilateral occlusion of a fallopian tube in 3, spasm of the tubes in 12, adhesions in 3, and stenosis in 3. All endometrial biopsies showed secretory endothelium. Within 3 cycles after repeated insemination 65% became pregnant; within 6 cycles, 88.9%. The longest period was 12 cycles. Basal body temperatures showed 30.5% became pregnant on day of ovulation, 65.7% between inseminations done a day before and a day after ovulation, 87% from Day 8 to Day 22 after onset of previous menstruation; pregnancies occurred from Day 10 to Day 23. For individuals with maximum cervical mucus pregnancy most often occurred. Patients showing luteal insufficiency were given oral hormone therapy. The earliest positive Asheim-Zondek reaction was on Day 36 after the last period, Day 25 after insemination. This was Day 20 after rise in body temperature. Miscarriage resulted in 14 instances (12.9%); 9 had shown luteal insufficiency. Among 60 deliveries 47 were normal, 1 premature, 9 cesarean, 1 forceps delivery, and 2 stillbirths. Of 50 newborn 32 were male and 26 female. When insemination was done before calculated ovulation 68% were male; when after, 75% were female. Pregnancy in the 6 cases with extreme uterine hypoplasia was noteworthy. It was concluded that the active period of sperm is longer than formerly believed. The cervical mucus was a better indicator than basal body temperature for estimation of ovulation. Fewer pregnancies occurred and miscarriages were more frequent when insufficiency of luteal function had been shown.