Intra-uterine insemination for unexplained subfertility

Area of Science:

• Reproductive Medicine
• Infertility Treatments

Background:

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

Purpose of the Study:

• To evaluate if IUI improves live birth rates compared to timed intercourse (TI) or expectant management.
• To assess the impact of ovarian hyperstimulation (OH) on IUI outcomes for couples with unexplained subfertility.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Searched multiple databases including Cochrane, MEDLINE, and EMBASE up to December 2015.
• Included 14 RCTs involving 1867 women with unexplained subfertility.

Main Results:

• No conclusive evidence of a difference in live birth rates between IUI and TI in natural or stimulated cycles.
• IUI in a stimulated cycle showed a potential increase in live birth rates compared to IUI in a natural cycle.
• No significant difference in multiple pregnancy rates was found for most comparisons.

Conclusions:

• Most comparisons between IUI and TI, with or without OH, did not show a significant difference in live birth or multiple pregnancy rates.
• Insufficient data for pooling on key outcomes across all comparisons.
• Further research is needed to clarify the role of IUI in fertility treatment.