What Is IUI — and Why Does Preparation Matter?
Intrauterine insemination (IUI) is a fertility treatment in which washed (prepared), concentrated sperm is placed directly into the uterus through a thin catheter around the time of ovulation.[^1][^2] By depositing motile sperm past the cervix and closer to the fallopian tubes, IUI increases the number of sperm that can reach the egg.[^4][^5]
Fertilization in IUI happens inside your body — not in a laboratory dish. The clinic places the sperm in the right place at the right time. The rest is biology.[^2][^4] That’s why the procedure itself takes less than 10 minutes, and why most of what determines its outcome is decided before you arrive.
TIP FROM THE EMBRYOLOGIST The IUI procedure itself does not guarantee that sperm will reach the egg Patients sometimes assume that because the sperm was placed inside the uterus, fertilization is more or less guaranteed — and that a negative result means something went wrong. It doesn’t. The sperm still needs to travel up the fallopian tube to reach the egg, penetrate the cumulus oophorus (surrounding cell layer) and zona pellucida (the outer shell), and achieve fertilization on its own. IUI bypasses the cervix and brings sperm closer to the tubes — but it does not place sperm at the egg. The modest per-cycle success rates reflect this biological reality, not a failure of preparation. |
Bottom Line:
IUI improves the probability of conception. It doesn’t replace conception. That distinction is the difference between expecting a guarantee and preparing for a high-effort improvement in your odds.
→ Learn more: Intrauterine Insemination (IUI)
What Investigations Should Be Completed Before IUI?
Before your first IUI cycle, four things must be confirmed: at least one patent fallopian tube, documented ovulation, a partner's semen analysis (or donor sperm selected), and a clear monitoring plan for the cycle.[^9] Skipping any of these turns, IUI becomes guesswork.
At least one open fallopian tube is non-negotiable. Without tubal patency, sperm have nowhere to meet the egg, and IUI cannot work.[^2][^9] Tubal status is typically confirmed via hysterosalpingography (HSG) or hysterosalpingo-contrast sonography (HyCoSy or HyFoSy). Ovulation is confirmed by regular cycles, day-21 progesterone levels, or ultrasound monitoring.[^9]
Your partner’s semen analysis is just as essential as your own evaluation. The number that determines IUI eligibility isn’t the headline sperm count — it’s the post-wash total motile sperm count (TMSC), measured after the lab has processed the sample.[^2][^8] A recent study confirmed that post-processing parameters predict pregnancy outcomes more reliably than pre-processing values.[^15] Below 5 million TMSC, IUI success is expected to be generally lower, and intracytoplasmic sperm injection (ICSI) may be the better option.[^2][^8]
→ Diagnostic test: Hysterosalpingography (HSG)
→ Diagnostic test: Semen Analysis (Spermiogram)
What Are Your IUI Protocol Options?
IUI can be performed in a natural (unstimulated) cycle or combined with ovarian stimulation (OS) — medications that encourage the ovaries to develop one or more mature follicles.[^2][^3] The protocol you and your doctor choose affects both your success rate and your level of monitoring.
Natural Cycle IUI
No fertility medications are used. IUI is timed to your own ovulation using luteinizing hormone (LH) monitoring or ultrasound.[^1][^3] This is the lowest-intervention option, and it suits women with regular ovulatory cycles, donor sperm cases, or ejaculatory dysfunction — situations where the goal is timing, not stimulation.
Stimulated IUI
Ovarian stimulation combined with IUI is usually the recommended first-line medical treatment for most couples with unexplained infertility.[^3] Three medication classes are used:
Clomiphene citrate — an oral medication that’s been used for decades; per-cycle live birth rate of about 8.9% with multiple-pregnancy rates of 0–12.5%.[^3]
Letrozole — an aromatase inhibitor with similar efficacy to clomiphene (about 9.4% per cycle in one large cohort study of 14,519 cycles) and a lower multiple-pregnancy rate (1.3% vs. 4.6%).[^3]
Gonadotropins — injectable hormones that produce stronger stimulation but carry a significantly higher risk of multiple pregnancy — up to 32% in some trials, including triplets and quadruplets.[^3] Generally not first-line for unexplained infertility.
Per-cycle live birth rates also matter less than the cumulative picture, and they vary widely by age, diagnosis, sperm parameters, and other factors.[^10] The American Society for Reproductive Medicine (ASRM) recommends 3–4 cycles of stimulated IUI with oral medications before transitioning to IVF.[^3]
→ Learn more: Ovulatory Disorders
How Should the Woman Prepare?
Female preparation for IUI centers on three things: baseline scans, cycle monitoring, and knowing what to expect on the day. Each one feeds the same goal — placing sperm in the uterus during the brief window where it can actually reach the egg.
Why Does Monitoring Matter So Much?
Because the window is narrow, ovulation doesn’t always wait for the clinic’s schedule. Monitoring combines two tools — ultrasound tracking of follicular growth and detection of the LH surge through urinary or serum testing.[^1][^7] Both matter.
A 2011 prospective cohort study of 87 ultrasound-monitored IUI cycles found that 28.7% had a spontaneous LH surge before the human chorionic gonadotropin (hCG) trigger was scheduled.[^7] If the surge isn’t detected, the insemination is timed wrong — sometimes by hours, occasionally by more than a day. That’s not a rounding error. The window for IUI relative to ovulation is measured in hours, and a single IUI timed 0–36 hours after hCG is as effective as a double IUI when timing is correct.[^3][^8]
Bottom Line:
Monitoring isn’t optional. It’s the difference between on-time and almost-on-time — and almost-on-time IUI is functionally a missed cycle.
What Should You Expect on the Day?
The IUI itself usually takes less than 10 minutes.[^1] A thin, flexible catheter is guided through the cervix, and the prepared sperm is deposited into the uterine cavity. Most women describe it as comparable to a Pap smear — but not identical. Some experience mild cramping. A few experience a sharper, briefer cramp as the catheter passes the internal cervical os.
TIP FROM THE EMBRYOLOGIST Expect a brief moment that may feel sharper than a Pap smear Patients are often told IUI is “like a smear test,” which is broadly true — but not entirely. A Pap smear uses a fixed speculum; IUI additionally involves passing a catheter through the internal cervical os. For women with a tight cervix, a significantly flexed uterus, or a history of cervical procedures, this can cause a sharper cramp than expected. It is brief, manageable, and not a cause for concern — but knowing in advance prevents the panic when it happens. |
Some clinics ask you to arrive with a full bladder because a full bladder can straighten the angle between the cervix and uterus, making catheter passage easier. Others prefer an empty bladder. Don’t guess — confirm with your clinic the day before. It’s a small detail, but it can affect comfort during the procedure.
When Might the Cycle Be Canceled?
In stimulated cycles, if monitoring shows three or more mature follicles developing, many guidelines and clinics recommend canceling the cycle — or at least withholding insemination — rather than proceeding.[^3] The reason is risk: the chance of high-order multiple pregnancy (triplets or more) becomes unacceptably high, and these pregnancies carry serious maternal and neonatal risks.
TIP FROM THE EMBRYOLOGIST A canceled cycle is not a failed cycle Cancellation is the hardest decision to accept emotionally — you’ve been through an intense stimulation cycle, paid for monitoring, and are emotionally invested in the outcome. Patients sometimes push back. The decision is correct anyway. A canceled cycle is a risk-managed cycle, and the information your team gathered — how your ovaries responded, what dose produced what result — directly improves the protocol for your next attempt. The risk of triplets and the resulting maternal and neonatal complications is real and not worth taking. |
→ Learn more: Polyendocrine Metabolic Ovarian Syndrome (PMOS)
How Should the Male Partner Prepare?
Male preparation for IUI breaks into two timeframes: the 74-day spermatogenesis window before the cycle (where lifestyle changes act), and the collection day itself, where small details can invalidate weeks of preparation. Both matter.[^18][^11]
How Long Should You Abstain?
The World Health Organization (WHO) recommends an abstinence period of 2 to 7 days before sperm collection for fertility treatments, with 3 to 5 days considered the practical sweet spot.[^16] Shorter abstinence reduces volume and total count. Longer abstinence may increase sperm count, but it can degrade motility and raise DNA fragmentation.[^16]
But your baseline sperm quality changes the answer. A 2024 analysis of 4,423 semen samples found that the optimal abstinence window depends on whether your parameters are normal or pathological — men with already-adequate counts may produce a better-quality sample after shorter abstinence, while men with subnormal parameters often improve with a slightly longer window.[^16] Your clinic may give different instructions than the WHO default. Follow them — they’re deliberate.
What Is the Lab Actually Measuring?
The single most important number for IUI is the post-wash total motile sperm count — sometimes called the total progressive motile sperm count (TPMSC). It’s what’s left after the laboratory has separated motile, morphologically normal sperm from seminal fluid, debris, and dead cells using density gradient centrifugation or a swim-up technique.[^11]
A 2023 prospective cohort study confirmed that post-processing semen parameters are more prognostic than pre-processing values.[^15] The pre-wash number on your last semen analysis report tells you something about your baseline biology. The post-wash number tells your fertility team whether IUI is the right procedure for you on this cycle. A 2024 study added that improvement in post-wash motility across successive IUI cycles is associated with better outcomes — so even small gains between cycles aren’t cosmetic.[^17]
What Happens on Collection Day?
On the day of insemination, the male partner produces a fresh semen sample — usually at the clinic, sometimes at home — which the laboratory processes before the insemination window closes. The standard collection method is masturbation into a sterile container provided by the clinic. No standard condoms, lubricants, or saliva can be used — all of them can kill sperm outright or may alter motility.[^11][^18]
TIP FROM THE EMBRYOLOGIST Timing the sample arrival is as important as the sample’s quality The sperm sample must be at the lab and processed before the insemination window closes. For a trigger-shot IUI, the procedure is typically 24–36 hours post-trigger, and the lab needs at least 60 minutes to wash and prepare the sample. Patients who are slow to arrive, who produce the sample at home without coordinating transport, or who arrive late can miss the optimal insemination window. Confirm with the clinic the exact time you need to arrive and present the sample — don’t estimate. |
→ Companion guide: What to Do Before Semen Analysis
What Lifestyle Changes Help in the Weeks Before?
Lifestyle preparation for IUI runs on two different clocks. For the male partner, the relevant window is approximately 74 days — the length of one complete spermatogenesis cycle.[^11] For the female partner, the egg developing for this cycle started its final maturation phase roughly 90 days before ovulation, so changes started 2–3 months out have time to act.[^18] Either way, the night before is too late.
What Both Partners Should Address
Several lifestyle factors are independently associated with reduced fertility in both partners. A 2016 review of lifestyle and assisted reproductive outcomes found that smoking, excessive alcohol, caffeine, and bisphenol A (BPA) exposure all have measurable effects on IVF and IUI outcomes.[^18]
Smoking is the most consistently damaging for sperm parameters and for ovarian function, and the only reliable intervention is stopping it, ideally 3 months before treatment.[^11][^18] Excessive alcohol affects both partners; moderate intake during preparation is the sensible default. Heavy caffeine consumption has been associated with reduced fertility, though the evidence is less consistent than for smoking or alcohol.[^18]
Does Diet Actually Matter?
A Mediterranean-style diet — high in vegetables, fruit, fish, olive oil, and whole grains — has the best-supported evidence base of any general dietary pattern in the fertility literature. A 2024 systematic review of 10 studies on the Mediterranean diet and semen quality found that 6 out of 10 studies showed a positive association with semen quality, primarily on sperm motility and concentration.[^12] A 2023 systematic review of antioxidant supplementation in men identified positive effects on semen parameters and assisted reproduction outcomes across 29 studies.[^13]
Specific antioxidants with the strongest evidence: CoQ10 (sperm concentration), L-carnitine (sperm motility), and vitamin C (sperm morphology).[^14] Most of this evidence is from trials in men with subfertility — for men with already normal parameters, supplementation rarely produces dramatic shifts.
What About Stress?
The honest answer is that stress is more often a consequence of fertility treatment than a proven direct cause of its failure. Patients undergoing IUI experience anxiety and fertility-specific distress comparable to those undergoing IVF.[^20] A 2013 pilot study confirmed that the highest stress arc occurs during the post-insemination waiting period — not before or during the procedure.[^21] Stress management matters because it makes the treatment endurable, not because reducing stress will, on its own, change a pregnancy outcome.
→ Learn more: Does Stress Cause Infertility?
How Should You Time Your Preparation?
Time each action to the biological window during which it can actually be effective. The table below maps every preparation step to the right moment in the IUI cycle.
Timing | Both Partners | Specific to Male Partner |
|---|---|---|
90 days before | Stop smoking, cut excessive alcohol, switch to a Mediterranean-style diet, address obvious heat exposure, and review medications with your doctor. | Begin antioxidant supplementation if recommended by your specialist (CoQ10, carnitine, vitamin C). |
30 days before | Confirm investigations are complete: tubal patency, ovulation, semen analysis. Flag any fever above 38°C in the past 3 months. | Avoid testosterone, anabolic steroids, and long courses of nonsteroidal anti-inflammatory drugs (NSAIDs) unless cleared by your fertility specialist. |
7 days before | Confirm the cycle protocol with your clinic — whether natural or stimulated, the monitoring schedule, and trigger timing. | Begin the abstinence window — typically 3–5 days, unless the clinic specifies otherwise based on baseline parameters. |
Day of insemination | Both partners arrive at allocated times with photo ID. Confirm bladder requirements with the clinic. Bring records of any medications taken. | Produce the fresh sample within the clinic’s required window — typically at least 60 minutes before insemination, so the lab can process it. |
After IUI | Continue any prescribed luteal support. Take the pregnancy test on the date your clinic instructs — usually about 2 weeks later. Don’t draw conclusions from a single cycle. | Maintain lifestyle changes for the next cycle if needed — spermatogenesis is continuous, so the work compounds. |
Sources: ASRM Practice Committee (2020);[^3] NICE NG257 (2023);[^9] Rotimi et al. (2024);[^11] Hornstein (2016)[^18]
What Happens at the Clinic on the Day?
On the day of insemination, both partners arrive at allocated times — and the times are rarely the same. The female partner needs time for preparation; the male partner needs to produce the sample early enough for the laboratory to process it before the insemination window opens.
Reception confirms identity, and the sample goes straight to the laboratory. But processing doesn’t begin right away — a fresh sample first needs about 30 minutes in an incubator to liquefy before the lab can work with it. The insemination itself takes about 5–10 minutes. After the procedure, you’ll typically be asked to rest briefly — evidence on whether this improves pregnancy rates is mixed but slightly favorable, and there’s no downside.[^2][^3]
TIP FROM THE EMBRYOLOGIST Arrive on time, with both IDs The reception needs to see both of your photo IDs to confirm your identities, so make sure neither of you forgets them at home. For the male partner, arrive at your allocated collection time — the laboratory needs enough time to wash and prepare the sample before insemination. For the female partner, timing also matters — preparations before the procedure take time. The two of you are usually scheduled separately for a reason; respect those windows. |
What Happens After IUI?
After your IUI, you enter the two-week wait — the period between insemination and your pregnancy test. Physically, most women feel completely normal. Some experience mild cramping for a few hours, light spotting, or fatigue if progesterone supplementation is part of the protocol. Anything more dramatic — severe abdominal pain, bloating, breathlessness, or rapid weight gain — needs urgent clinical attention.[^1]
Important:
If you’ve been on ovarian stimulation and you develop severe abdominal pain, bloating, nausea, or difficulty breathing in the days after IUI, contact your clinic immediately or seek emergency care. These can be signs of ovarian hyperstimulation syndrome (OHSS), which is uncommon but requires prompt treatment.[^1]
Take the pregnancy test on the date your clinic specifies — usually about 14 days after insemination. Earlier testing risks both false positives (residual hCG from a trigger shot) and false negatives (testing before implantation has produced enough hCG to detect).[^1]
Why the Two-Week Wait Is So Hard
Research has identified the post-insemination waiting period as the highest-stress phase of an IUI cycle — higher than the run-up to the procedure itself.[^21] A 2025 study of patients undergoing IUI confirmed that longer infertility duration, younger age (linked to greater social pressure), financial stress, and repeated failed cycles all increase psychological distress.[^20]
The European Society of Human Reproduction and Embryology (ESHRE) recommends structured psychosocial support as part of routine fertility care — not as an add-on for those who “need help,” but as a standard component of treatment.[^19] Talking to a partner, a counselor, or others going through the same process is associated with better treatment endurance and adherence.
TIP FROM THE EMBRYOLOGIST IUI is a numbers game — one cycle is not the whole story The per-cycle live birth rate for IUI is approximately 8–15% in most populations, depending on age, diagnosis, semen parameters, and protocol. That means any single cycle has roughly an 85–92% chance of not producing a pregnancy — and that’s the baseline biology, not a failure of preparation or procedure. The cumulative picture across 3 or 4 cycles is much more informative, and for well-selected patients, cumulative success across four stimulated IUI cycles compares reasonably to a single IVF cycle at a fraction of the cost and physical burden. Stopping after a single unsuccessful cycle, assuming something has gone wrong, is usually premature. One failed IUI means very little clinically. A pattern across multiple cycles tells a story. |
If the Result Is Negative
A negative pregnancy test after IUI is not the end of the road. Most pregnancies through IUI occur within the first 3–4 cycles, and many couples need more than one attempt.[^2][^3] Your fertility team will review the cycle — how you responded, the post-wash numbers, the timing — and may adjust the protocol for the next attempt or recommend transitioning to IVF if cumulative outcomes suggest it.
Evidence strongly supports moving to IVF after 3–4 unsuccessful stimulated IUI cycles with oral medications, rather than escalating to gonadotropin-IUI.[^3][^6] For women aged 38 and over, the case for skipping straight to IVF is even stronger — one randomized trial found live birth rates of 31.4% with immediate IVF versus 15.7% with clomiphene-IUI in women with a mean age of 40.[^3]
→ Treatment option: In Vitro Fertilization (IVF)
So, What Should You Do Now?
If you’re preparing for IUI, here’s the order of operations.
Step 1: Confirm Your Investigations Are Complete
Before your first IUI cycle, confirm at least one patent tube, documented ovulation, and a recent partner semen analysis. Without these, IUI is guesswork. Ask your clinic which investigations are still pending and what’s needed before the cycle starts.
Step 2: Understand Your Protocol
Ask whether your IUI will be natural or stimulated, what monitoring schedule applies, and what the trigger plan is. If you’re on stimulation, confirm how cycle cancellation decisions will be made — including the rule about three or more mature follicles. Knowing the plan in advance reduces panic if it changes.
Step 3: Time Your Lifestyle Changes Correctly
Stop smoking, cut excessive alcohol, and start the dietary changes ideally 2–3 months before the cycle. For the male partner, the spermatogenesis cycle is approximately 74 days — there’s no shortcut to good preparation. If you can’t manage 90 days, do what you can with the time you have.
Step 4: Hit the Day of the Procedure Cleanly
Both partners arrive on time with photo ID. The male partner produces the sample at the time the clinic specifies — not when convenient. The female partner confirms bladder requirements the day before. Bring a list of any medications you have taken in the past 3 months for the lab to reference.
Step 5: Treat the Two-Week Wait as Its Own Phase
Don’t test early. Don’t draw conclusions from a single cycle. The post-insemination waiting period is the most psychologically demanding part of the cycle — schedule lighter weeks if you can, and consider talking to someone going through the same process. If the test is negative, your team has data to refine the next cycle. If it’s positive, contact the clinic for follow-up monitoring.
Step 6: Choose the Right Clinic
Not every clinic publishes IUI success rates in the same way, and not every clinic offers stimulated and natural protocols with equal expertise. Compare clinics, ask for transparent per-cycle and cumulative live birth rates by age group, and confirm that both partners can be evaluated and treated by the same team. A clinic that communicates clearly about when to adjust course is more valuable than one with the highest advertised rates.
→ Compare fertility clinics worldwide: MedicalNavigator.com/fertility-clinics
Too Long, Didn’t Read
IUI is a 10-minute procedure with a per-cycle live birth rate of approximately 8–15% — preparation in the weeks before matters more than the procedure itself.
Before your first cycle, confirm at least one patent tube, documented ovulation, and a recent semen analysis — IUI without these is guesswork.
Spontaneous LH surges occur in about 28.7% of ultrasound-monitored cycles, which is why combined monitoring is more reliable than ultrasound alone.
Abstain from ejaculation for 2 to 7 days before collection, with 3–5 days as the practical default — your clinic may specify differently based on your baseline parameters.
The post-wash motile sperm count predicts IUI success more reliably than the pre-wash number — below 5 million, ICSI may be a better option.
Most pregnancies occur within the first 3–4 stimulated IUI cycles — if these don’t succeed, evidence supports moving to IVF rather than escalating to gonadotropin-IUI.
References
[^1]: United Kingdom National Health Service (NHS). Intrauterine insemination (IUI). Reviewed 2024.
[^2]: Allahbadia GN. Intrauterine Insemination: Fundamentals Revisited. J Obstet Gynaecol India. 2017;67(6):385–392.
[^3]: Practice Committee of the American Society for Reproductive Medicine. Evidence-based treatments for couples with unexplained infertility: A guideline. Fertil Steril. 2020;113(2):305–322.
[^4]: Chronopoulou E, Gaetano-Gil A, Shaikh S, et al. Optimizing intrauterine insemination: A systematic review and meta-analysis of the effectiveness and safety of clinical treatment add-ons. Acta Obstet Gynecol Scand. 2024;103(10):1919–1932.
[^5]: Carson SA, Kallen AN. Diagnosis and Management of Infertility: A Review. JAMA. 2021;326(1):65–76.
[^6]: Chiu Y-H, et al. Effectiveness and safety of intrauterine insemination versus immediate assisted reproductive technology for infertility. Fertil Steril. 2022;118(3):523–532.
[^7]: Antaki R, Dean NL, Lapensée L, Racicot M-H, Ménard S, Kadoch IJ. An algorithm combining ultrasound monitoring and urinary luteinizing hormone testing: a novel approach for intrauterine insemination timing. J Obstet Gynaecol Can. 2011;33(12):1248–1252.
[^8]: Zhang N, Zhou H. Optimizing timing for intrauterine insemination (IUI) in donor sperm cycles: pre- versus post-ovulation insemination in natural cycles. Gynecological Endocrinology. 2024;40(1).
[^9]: National Institute for Health and Care Excellence. Fertility problems: assessment and treatment. NICE Guideline NG257. 2023.
[^10]: Dias CMF, Vitorino GBT, Furlan SMP, et al. Intrauterine insemination: prognostic factors. JBRA Assist Reprod. 2024;28(2):254–262.
[^11]: Rotimi SO, et al. Implications of lifestyle factors on male reproductive health. J Reprod Infertil. 2024;25(2):79–91.
[^12]: Piera-Jordan CA, Prieto Huecas L, Serrano De La Cruz Delgado V, et al. Influence of the Mediterranean diet on seminal quality — a systematic review. Front Nutr. 2024;11:1287864.
[^13]: Smits RM, Mackenzie-Proctor R, Yazdani A, Stankiewicz MT, Jordan V, Showell MG. Antioxidant supplementation on male fertility — a systematic review. Antioxidants. 2023;12(4):836.
[^14]: Su L, Qu H, Cao Y, et al. Effect of Antioxidants on Sperm Quality Parameters in Subfertile Men: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2022;13(2):586–594.
[^15]: Dahan MH, Tan SL, Nair S, Feinberg Isaacs T. An Analysis of Pre and Post-Processing Semen Parameters at the Time of Intrauterine Insemination; and the Confounding Effects of Total Motile Sperm Counts on Pregnancy Outcome: A Prospective Cohort Study. Int J Fertil Steril. 2023;18(1):20–25.
[^16]: Xie M, Hämmerli S, Leeners B. The Association between Abstinence Period and Semen Parameters in Humans: Results in Normal Samples and Different Sperm Pathology. Life (Basel). 2024;14(2):188.
[^17]: Taniguchi M, Kanasaki H, Oride A, Okada H, Imamura K, Kyo S. Impact of current and previous sperm findings on outcomes of intrauterine insemination. Reprod Med Biol. 2024;23:e12574.
[^18]: Hornstein MD. Lifestyle and IVF Outcomes. Reproductive Sciences. 2016;23(12):1626–1629.
[^19]: Gameiro S, Boivin J, Dancet E, et al. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction — a guide for fertility staff. Hum Reprod. 2015;30(11):2476–2485.
[^20]: Starosta A, Gordon CE, Hornstein MD. Predictive factors for intrauterine insemination outcomes: a review. Fertil Res Pract. 2020;6:23.
[^21]: Turner K, Reynolds-May MF, Zitek EM, Tisdale RL, Carlisle AB, Westphal LM. Stress and anxiety scores in first and repeat IVF cycles: a pilot study. PLoS One. 2013;8(5):e63743.
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