Intrauterine Insemination or In-Vitro Fertilisation in Idiopathic Subfertility and Male Subfertility: A Randomised Trial and Cost-Effectiveness Analysis

Goverde, Angelique J.; McDonnell, Joseph; Vermeiden, Jan P.W.; Schats, R.; Rutten, Frans; Schoemaker, Jopp

doi:10.1097/00006254-200005000-00020

Cited by 59 publications

(119 citation statements)

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“…Two papers in the New England Journal of Medicine reported 4393 cycles of COH‐IUI, with a multiple pregnancy rate of 30%, of which 8–9% were triplets or more 1,2 . In contrast, a Dutch study in the Lancet also showed a 30% multiple pregnancy rate, but all were twins 3 …”

Section: Comparison Of Calculated Besst From Different Authorsmentioning

confidence: 99%

Prevention of multiple gestation in controlled ovarian stimulation: Introduction to Theme

Healy

2006

Aust NZ J Obst Gynaeco

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S23increase, and then raised to 150 IU. Human chorionic gonadotrophin (hCG) was withheld if there were three follicles >14 mm diameter. Using this protocol, BESST rates were approx 6%.We had one triplet birth in 510 COH-IUI cycles.Ovulation induction in Australia has used 37.5-50 IU FSH for at least 5 days, before any increase to 50 IU or 75 IU FSH. The hCG was withheld when there were three follicles >15 mm diameter, BESST rates with OI were 8-13% with 5-10% twins.These data contrast with US publications reporting 30% multiple pregnancy rates, with 8-9% triplets, quadruplets or quintuplets, from COH-IUI or OI. The rate of multiple pregnancy with OI is 'a grave disservice to patients'. 5 Reports from the USA suggest that multiple pregnancies and births result from OI and COH-IUI in approximately 40% of instances, and there are 'no guidelines '. 6 Wilcox et al. reported a BESST rate from 221 normal couples who were attempting pregnancy. 7 Urinary hCG was measured in 707 cycles and 112 births were assessed. The mean age was 26-30 years and BESST was 16%; this is similar to our own work.There were 155 pregnancies and 43 early pregnancy losses. Min et al.

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Section: Comparison Of Calculated Besst From Different Authorsmentioning

confidence: 99%

Prevention of multiple gestation in controlled ovarian stimulation: Introduction to Theme

Healy

2006

Aust NZ J Obst Gynaeco

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“…(), offering the opportunity to completely bypass many etiologies of male infertility, as it only requires one functionally normal spermatozoa per oocyte (Palermo et al ., ). However, IVF and ICSI come with significantly increased potential cost and morbidity to the patient and offspring compared to IUI (Goverde et al ., ). Recent studies have called into question the predictive value of sperm morphology for pregnancy and the need to move directly to ICSI in those with teratozoospermia (Matorras et al ., ; Karabinus & Gelety, ; Check et al ., ; Deveneau et al ., ).…”

Section: Introductionmentioning

confidence: 97%

Isolated abnormal strict morphology is not a contraindication for intrauterine insemination

et al. 2015

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SUMMARYThis study sought to investigate whether isolated abnormal strict morphology (<5% normal forms) and very low strict morphology (0-1% normal forms) affects pregnancy rates in intrauterine insemination (IUI). This was a retrospective study performed at an Academic Medical Center/Reproductive Medicine Center. Four hundred and eight couples were included for 856 IUI cycles. 70 IUI cycles were performed in couples with abnormal strict morphology and otherwise normal semen parameters. Outcomes were measured as clinical pregnancy rate per IUI cycle as documented by fetal heart activity on maternal ultrasound. Clinical pregnancy rate did not significantly differ between the group with abnormal strict morphology [11/70 (15.7%)] and the normal morphology group [39/281 (13.9%)]. Additionally, there was no significant difference between the pregnancy rate in the abnormal morphology group compared to that of our overall institutional IUI pregnancy rate [145/856 (16.9%)]. Furthermore, there was no significant difference between pregnancy rate in the very low morphology group [3/14 (21.4%)] compared to those with normal morphology or the overall IUI pregnancy rate. Patients with isolated abnormal strict morphology have clinical pregnancy rates similar to those with normal morphology for IUI. Even in those with very low normal forms, consideration of IUI for assisted reproduction should not be excluded.

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“…suggests that existing treatments such as empirical clomifene citrate and natural IUI do not offer superior live birth rates compared with expectant management in poorly explained infertility. Composite data from studies in the 1980s and 1990s showed pregnancy rates of up to 17% with IUI and 20.7% with IVF . Two randomised controlled trials (RCT) compared IUI with IVF in couples with poorly explained infertility .…”

Section: Introductionmentioning

confidence: 99%

“…Composite data from studies in the 1980s and 1990s showed pregnancy rates of up to 17% with IUI and 20.7% with IVF . Two randomised controlled trials (RCT) compared IUI with IVF in couples with poorly explained infertility . The Goverde et al .…”

Section: Introductionmentioning

confidence: 99%

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A randomised controlled trial of intra-uterine insemination versusin vitrofertilisation in patients with idiopathic or mild male infertility

Elzeiny

Garrett

Toledo

et al. 2014

Aust N Z J Obstet Gynaecol

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Intrauterine Insemination or In-Vitro Fertilisation in Idiopathic Subfertility and Male Subfertility: A Randomised Trial and Cost-Effectiveness Analysis

Cited by 59 publications

References 0 publications

Prevention of multiple gestation in controlled ovarian stimulation: Introduction to Theme

Prevention of multiple gestation in controlled ovarian stimulation: Introduction to Theme

Isolated abnormal strict morphology is not a contraindication for intrauterine insemination

A randomised controlled trial of intra-uterine insemination versusin vitrofertilisation in patients with idiopathic or mild male infertility

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