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Immobilization or mobilization after IUI: an RCT.
J van Rijswijk1, M R Caanen1, V Mijatovic1
1Department of Reproductive Medicine, VU University Medical Centre, De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands.
Human Reproduction (Oxford, England)
|October 18, 2017
Summary
Immobilization for 15 minutes after intrauterine insemination (IUI) does not improve pregnancy rates. This study found no benefit, suggesting the practice is not justified based on current evidence for improving conception success.
Area of Science:
- Reproductive Medicine
- Infertility Treatment
- Clinical Trials
Background:
- Previous studies suggested a potential benefit of 15-minute supine immobilization post-intrauterine insemination (IUI).
- These prior findings have been criticized, and the biological plausibility remains questionable.
- The need for evidence-based practice in daily fertility treatments prompted this replication study.
Purpose of the Study:
- To investigate whether a 15-minute period of supine immobilization following IUI enhances pregnancy rates compared to immediate mobilization.
- To provide robust data for clinical decision-making regarding post-IUI procedures.
Main Methods:
- A single-center randomized controlled trial (RCT) conducted in the Netherlands.
- 498 couples undergoing IUI for unexplained or mild male subfertility were randomized.
- Participants were assigned to either 15 minutes of supine immobilization or immediate mobilization post-IUI for up to six cycles.
Main Results:
- The ongoing pregnancy rate per couple was not superior in the immobilization group (32.2%) compared to the immediate mobilization group (40.0%).
- No significant differences were observed in miscarriage rates, multiple gestation rates, live birth rates, or time to pregnancy.
- The relative risk for pregnancy in the immobilization group was 0.81 (95% CI [0.63, 1.02]).
Conclusions:
- This study demonstrates that 15 minutes of immobilization after IUI does not positively impact pregnancy rates.
- The evidence does not support the routine implementation of post-IUI immobilization for improving conception.
- Further research may be needed, but current data suggest this practice is not beneficial.