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Related Experiment Videos

In vitro fertilisation for unexplained subfertility.

Z Pandian1, S Bhattacharya, L Vale

  • 1Department of Obstetrics & Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen, UK, AB15 2ZD. z.pandian@abdn.ac.uk

The Cochrane Database of Systematic Reviews
|April 23, 2005
PubMed
Summary
This summary is machine-generated.

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The effectiveness of in vitro fertilisation (IVF) for unexplained infertility is unclear. While IVF showed higher clinical pregnancy rates than expectant management, live-birth rates compared to other treatments like intrauterine insemination (IUI) and GIFT remain unknown due to limited data.

Area of Science:

  • Reproductive Medicine
  • Infertility Treatment
  • 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.
  • Concerns regarding IVF's complications and costs necessitate rigorous evaluation against alternatives like expectant management and intrauterine insemination (IUI).

Purpose of the Study:

  • To compare the live-birth rates of IVF with expectant management, clomiphene citrate (CC), IUI alone, IUI with controlled ovarian stimulation, and gamete intrafallopian transfer (GIFT) in unexplained infertility.

Main Methods:

  • Systematic review and meta-analysis of randomised controlled trials (RCTs) identified through comprehensive database searches.
  • Primary outcome was live-birth rate per woman; secondary outcomes included clinical pregnancy and multiple pregnancy rates, and ovarian hyperstimulation syndrome (OHSS).

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Main Results:

  • Limited data from four RCTs were available for analysis, with significant heterogeneity.
  • No significant difference in live-birth rates was found between IVF and IUI (with or without stimulation) or GIFT.
  • IVF demonstrated significantly higher clinical pregnancy rates compared to expectant management and GIFT.

Conclusions:

  • The effectiveness of IVF for live-birth rates in unexplained infertility remains uncertain compared to other treatments.
  • Small sample sizes, inadequate follow-up, and underreporting of adverse effects limit current evidence.
  • Larger, well-powered trials are needed to establish IVF's efficacy, including reporting on adverse events and costs.