A common question that often arises is whether to perform the artificial insemination with or without ultrasound guidance. In both procedures, a catheter is inserted into the cervic to introduce sperm into the uterus, where the sperm will travel to the fallopian tube for fertilization with the egg.
Several studies now show that non-ultrasound guided artificial insemination is as good as ultrasound guided (the benefit of not having to use an ultrasound is that it makes AI even more economical). In this first study published in Human Reproduction, the pregnancy rates per cycle with ultrasound guidance is 16.0% and 16.8% without ultrasound guidance. Although it seems like non-ultrasound guidance pregnancy rates are higher, the difference is not statistically different. Another study published last year arrived at the same conclusion--that pregnancy rates or "success rates" are similar for both with or without ultrasound guidance. It is worth pointing out that both of these studies are randomized control trials, which are higher quality studies.
To give a more balanced perspective on this topic, there are some studies which show that ultrasound guided AI may be superior in cases where inter-utermine insemination is done on more difficult cases. More difficult cases may include variations in anatomy or uterine/cervix structure. Therefore, there certainly are situations when ultrasound can be very helpful.
Overall, I find the studies which show "equality" of with and without ultrasound guided AI reassuring. Many patients who opt for AI do so because they want a procedure that is less invasive and less expensive, and these studies support this choice as being very reasonable.