الفهرس 
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Abstract
Infertility is defined as the inability to conceive after one year of regular unprotected intercourse and accounts for one in six couples wishing to start a family.(1) Infertility in many couples has multiple etiologies however, in approximately 15-17% of couples, no reason for infertility is found and the infertility is considered unexplained.(2)
Assisted reproductive technology (ART) has become the frontier of infertility treatment and research. Nowadays ART is wide spread all over the world and has become one of the treatment modalities in infertile couples.(3)
Intrauterine insemination (IUI) has an important role in the treatment of infertile couples. IUI is a widely used and cost effective therapy for the treatment of infertility.(4) In fact intrauterine insemination has not been classified as Assisted Reproductive Technique despite it’s wide use.(5)
Intrauterine insemination was first introduced over 50 years ago. It is a rationale treatment for infertility secondary to a cervical factor, mild male factor and ejaculatory dysfunction but the most common indication is unexplained infertility.(6)It involves the preparation of a semen sample in the laboratory followed by its direct placement into the uterine cavity for fertilization.(7)
Many reports on the factors that affect successful IUI treatment like woman age, the duration and cause of infertility, sperm quality such as total motile sperm count, number of mature follicles, estradiol (E2) concentration on the day of hCG administration and the type of used catheter can influence the results of IUI.(8)
According to World Health Organization, (1980)(9) analysis of natural cycles, ovulation takes place from 24 to 56 h after the onset of the LH surge with a mean time of 32 h. Timing of ovulation in stimulated cycles also varies considerably and depends on the ovarian stimulation protocol used. Oocyte are fertilizable for only a period of 12-16 h. It has been shown that the period when an oocyte can be successfully fertilized begins 6 h after ovulation. This means that even if spermatozoa meet the oocyte in the fallopian tube at the time of ovulation there still are 6 h to the fertilizable period of the oocyte to start. This suggest that IUI after observation of ovulation should be preferred to IUI prior to or even to the exact time of ovulation.(10)
One of the most important topics affecting intrauterine insemination was the timming of the insemination. Accordingly, in the majority of the studies, the insemination was performed 32-36 h after hCG administration.(11) However it appear that among healthy women, the best chance to become pregnant is if intercourse occurs up to six days before ovulation.(12) If this is applied to intrauterine insemination protocol, the hCG should be injected after the insemination rather before it.