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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Intrauterine insemination
Human Reproduction Update, Volume 15, No. 3, Year 2009
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Description
Background: Intrauterine insemination (IUI) with or without ovarian stimulation is a common treatment for infertility. Despite its popularity, the effectiveness of IUI treatment is not consistent, and the role of IUI and in vitro fertilization (IVF) treatment in practice protocols has not been clarified. Methods: Medline searches were done by individual topics (utilization, procedures, effectiveness of partner but not donor IUI and related endocrine issues). Effectiveness of IUI was evaluated in relevant randomized controlled trials, using meta-analysis and meta-regression where necessary. Results: Stimulated IUI is ineffective in male infertility and the effect on other diagnoses is small. With clomiphene citrate and IUI, the most common IUI protocol, pregnancy rates average 7% per cycle. FSH ovarian stimulation and IUI treatment is only modestly better than observation only with pregnancy rate 12% per cycle but multiple birth rates averaging 13%. Mildly stimulated (1-2 follicles) cycles might reduce the cost and multiple birth rates but may require more cycles of treatment. Prevention of premature luteinizing hormone surges and luteal phase support do not appear to be major requirements in IUI cycles. Conclusions: IUI treatment requires ovarian stimulation to achieve modest results, but the high multiple pregnancy rates mean that it is no more than a poor substitute for IVF treatment. More trials are needed on IUI treatment with mild stimulation and on the order of IUI and other treatments. © The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.
Authors & Co-Authors
Aboulghar, Mohamed A.
Egypt, Giza
Cairo University
Baird, David T.
United Kingdom, Edinburgh
Mrc Centre for Reproductive Health
Collins, J.
Canada, Hamilton
Mcmaster University
Evers, Johannes L.H.Hans
Netherlands, Maastricht
Maastricht Universitair Medisch Centrum+
Fauser, Bart C.J.M.
Netherlands, Utrecht
University Medical Center Utrecht
Lambalk, C. B.Nils
Netherlands, Amsterdam
Amsterdam Umc - Vrije Universiteit Amsterdam
Somigliana, Edgardo D.
Italy, Milan
Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico
Sunde, Arne
Norway, Trondheim
Norges Teknisk-naturvitenskapelige Universitet
Tarlatzis, Basil C.
Greece, Thessaloniki
Ivf Center
Crosignani, Piergiorgio G.
Italy, Milan
Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico
DeVroey, Paul
Belgium, Brussels
Centrum Voor Reproductieve Geneeskunde
Diczfalusy, E.
Sweden, Stockholm
Karolinska Institutet
Diedrich, Klaus
Germany, Lubeck
Universitätsklinikum Schleswig-holstein Campus Lübeck
Fraser, L.
United Kingdom, London
King's College London
Geraedts, J. P.M.
Netherlands, Maastricht
Universiteit Maastricht
Gianaroli, L.
Italy, Bologna
S.i.s.me.r.
Glasier, Anna F.
United Kingdom, Edinburgh
Family Planning and ww Services
van Steirteghem, André C.
Belgium, Brussels
Centrum Voor Reproductieve Geneeskunde
Statistics
Citations: 173
Authors: 18
Affiliations: 16
Identifiers
Doi:
10.1093/humupd/dmp003
ISSN:
13554786
e-ISSN:
14602369
Research Areas
Maternal And Child Health
Sexual And Reproductive Health
Study Approach
Systematic review
Participants Gender
Male