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Related Experiment Videos

In vitro fertilisation for unexplained subfertility.

Z Pandian1, S Bhattacharya, D Nikolaou

  • 1Obstetrics & Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen, UK, AB25 2ZD. z.pandian@abdn.ac.uk

The Cochrane Database of Systematic Reviews
|June 22, 2002
PubMed
Summary
This summary is machine-generated.

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See all related articles

The effectiveness of in vitro fertilisation (IVF) compared to other infertility treatments remains unclear due to limited research. More powerful studies are needed to determine IVF

Area of Science:

  • Reproductive Medicine
  • Infertility Treatments
  • Clinical Trials

Background:

  • In vitro fertilisation (IVF) is a common treatment for unexplained infertility, but its effectiveness compared to other options is not well-established.
  • Livebirth rates per IVF cycle vary, prompting a need for rigorous evaluation against alternatives like expectant management and intrauterine insemination (IUI).
  • Concerns regarding complications and costs associated with IVF necessitate a comparative analysis with less invasive procedures.

Purpose of the Study:

  • To compare the livebirth probability of IVF against expectant management, clomiphene citrate (CC), IUI alone, IUI with controlled ovarian stimulation, and Gamete IntraFallopian Transfer (GIFT) for unexplained infertility.
  • To evaluate IVF's effectiveness in improving livebirth rates in couples with unexplained infertility.

Main Methods:

Related Experiment Videos

  • Systematic review and meta-analysis of randomised controlled trials (RCTs) identified through established search strategies.
  • Inclusion criteria focused on RCTs with livebirth rate per woman as the primary outcome.
  • Two independent reviewers assessed trial eligibility and quality; data extraction and analysis were performed subsequently.

Main Results:

  • Four RCTs were included in the analysis, comparing IVF with expectant management, IUI, IUI with ovarian stimulation, and GIFT.
  • No significant difference in livebirth rates was found between IVF and IUI (with or without ovarian stimulation).
  • No significant difference in clinical pregnancy rates was observed between IVF and expectant management or GIFT. Multiple pregnancy rates also showed no significant difference.

Conclusions:

  • The comparative effectiveness of IVF versus expectant management, clomiphene citrate, IUI, and GIFT for livebirth rates in unexplained infertility remains largely unknown.
  • Existing studies are limited by small sample sizes, infrequent reporting of livebirth rates, and insufficient data on adverse effects like multiple pregnancies and ovarian hyperstimulation syndrome (OHSS).
  • Larger, adequately powered trials are required to establish IVF's effectiveness, including reporting on adverse effects, costs, and influential factors such as female partner's age and infertility duration.