The rationale behind intrauterine insemination (IUI) with partner sperm is bypassing the cervical-mucus barrier and increasing the number of motile spermatozoa with a high proportion of normal forms at the site of fertilization. This chapter examines the value and position of homologous intrauterine insemination in an assisted reproductive technology (ART) program. Some of the factors influencing IUI success include site of insemination, number of inseminations, exact timing of IUI, sperm preparation methods and fallopian tube sperm perfusion. Artificial inseminations can be done intravaginally, intracervically (ICI), pericervically using a cap, intrauterine (IUI), transcervical intrafallopian (IFI) or directly intraperitoneal (IPI). Most studies refer to IUI, which seems to be an easy and better way of treatment. IUI should be promoted as the best first-line treatment in most cases of subfertility provided at least one tube is patent and an IMC after sperm preparation of more than 1 million can be obtained.

Achieving a distinct ovarian response usually represents the desired outcome of pharmacological interventions on the hypothalamic-pituitary-ovarian axis in ovulation induction and ovarian stimulation. The considerable individual variability in ovarian response to stimulation, however, necessitates close monitoring and dose adjustment for each woman. Combining prediction models for success in ovulation induction and success in conception would allow prediction of the likelihood of conception before anti-estrogen therapy is initiated, allowing women with a low percentage chance of a live birth to be directed towards another first-line treatment modality. Gonadotrophins are commonly used as a second-line treatment to restore ovarian function in women with WHO group II anovulation who have not responded to anti-estrogen therapy. Despite problems in using the current predictive tests in clinical practice, the wide variation in patients' characteristics mean that individualised patient-tailored approaches remain mandatory for safe and effective ovarian stimulation.