Intrauterine insemination with gonadotropin stimulation or in vitro fertilization for the treatment of unexplained subfertility: a randomized controlled trial

Fertility and Sterility
Anupa NandiRoy Homburg

Abstract

To evaluate the best first line management option for the treatment of unexplained subfertility-controlled ovarian hyperstimulation (COH) with gonadotropins and IUI or IVF. Randomized controlled trial. Single center trial in a tertiary referral unit. Couples with unexplained subfertility. Couples were randomized to receive either three cycles of IUI + COH or one cycle of IVF. Singleton pregnancy rate (PR) per couple. A total of 207 couples were randomly assigned to three cycles of IUI + COH (n = 101) or one cycle of IVF (n = 106). There were 25 (24.7%) singleton live births for the IUI + COH group and 33 (31.1%) for the IVF group (relative risk, 1.3; 95% confidence interval [CI] 0.81-1.96) with an absolute risk difference of 6.4% (95% CI -5.8% to 18.6%). The multiple pregnancies per live birth were 4 (13.8%) for the IUI + COH group and 3 (8.3%) for the IVF group (relative risk, 0.6; 95% CI 0.14-2.4). There were no cases of ovarian hyperstimulation syndrome (OHSS) in the IUI group and three cases of OHSS (3.7%) in the IVF group. There were 17 live births from spontaneous conception in between treatment cycles (8.2%). The singleton live birth rate with one cycle of IVF was not significantly different than three cycles of IUI + CO...Continue Reading

Citations

Sep 6, 2019·The Cochrane Database of Systematic Reviews·Rui WangMadelon van Wely
Aug 30, 2019·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Mustafa TaşYılmaz Sahin
Jul 18, 2018·Reproductive Medicine and Biology·Toshiya MatsuzakiMinoru Irahara
Jun 17, 2019·Current Urology Reports·Rachel B Danis, Mary K Samplaski
May 16, 2019·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Oladayo O OduolaNikhil Purandare
Oct 31, 2020·Seminars in Reproductive Medicine·Rui WangMadelon van Wely
May 26, 2021·Journal of Assisted Reproduction and Genetics·Nejc KozarMilan Reljič
Jun 22, 2021·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·Şeyma OsmanlıoğluCem Somer Atabekoğlu

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