Intra-uterine insemination for unexplained subfertility.

Area of Science:

• Reproductive Medicine
• Infertility Treatments
• Clinical Trials

Background:

• Intra-uterine insemination (IUI) is a common fertility treatment for unexplained subfertility.
• The safety and efficacy of IUI combined with ovarian hyperstimulation (OH) remain debated, particularly regarding multiple pregnancy rates.

Purpose of the Study:

• To evaluate if IUI improves live birth rates compared to timed intercourse (TI) for unexplained subfertility, with or without OH.
• To assess the impact of OH on IUI outcomes.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Searched multiple databases including Cochrane, MEDLINE, and EMBASE up to July 2011.
• Included RCTs comparing IUI versus TI in natural or stimulated cycles, and IUI with OH versus IUI without OH.

Main Results:

• IUI in stimulated cycles showed increased pregnancy rates compared to TI (OR 1.68, 95% CI 1.13 to 2.50).
• IUI with OH significantly increased live birth rates compared to IUI alone (OR 2.07, 95% CI 1.22 to 3.50).
• Insufficient data was available to assess live births, multiple pregnancies, and miscarriage risks associated with OH.

Conclusions:

• IUI with OH demonstrates an increased live birth rate compared to IUI alone.
• IUI in stimulated cycles is more effective than TI in terms of pregnancy likelihood.
• Couples must be fully informed of the potential risks and benefits of IUI with OH.