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Related Experiment Video

Updated: Aug 14, 2025

Fertility Preservation in Patients with Severe Ovarian Dysfunction

Fertility Preservation in Patients with Severe Ovarian Dysfunction

Published on: March 25, 2021

Alternatives to in vitro fertilization.

Jennifer A Wessel¹, Sarah Hunt², Madelon van Wely¹

¹Amsterdam UMC location University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam, the Netherlands; Amsterdam Reproduction and Development research institute, Amsterdam, the Netherlands.

Fertility and Sterility

|January 15, 2023

Summary

Concerns about in vitro fertilization (IVF) overuse prompt a review of alternatives. Evidence on the effectiveness, safety, and cost-effectiveness of IVF alternatives is summarized to guide reproductive medicine.

Keywords:

IUI IVC IVM expectant management tubal flushing

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Area of Science:

Reproductive Medicine
Infertility Treatments

Background:

Concerns exist regarding the overuse of in vitro fertilization (IVF) due to unproven effectiveness in some populations, safety risks, and cost.
Alternatives to IVF are underutilized in both clinical practice and research.

Approach:

This review synthesizes current evidence on the effectiveness, safety, and cost-effectiveness of various IVF alternatives.
Alternatives examined include expectant management, intrauterine insemination, tubal flushing, in vitro maturation, and intravaginal culture.
The review also analyzes IVF usage trends and discusses the role of alternatives in contemporary reproductive medicine.

Key Points:

Evidence on the effectiveness, safety, and cost-effectiveness of IVF alternatives is presented.
The trend of IVF utilization over the past decade is discussed.
The potential of intravaginal culture and its service tiers are explored.

Conclusions:

Revisiting the roles of IVF alternatives is crucial for modern reproductive medicine.
A balanced approach considering alternatives alongside IVF is recommended.
Further research into underappreciated IVF alternatives is warranted.