How successful is infertility treatment?

Costello MF.

Department of Reproductive Medicine and IVF Australia, Royal Hospital for Women, Randwick, Sydney, Australia. mfcostello@unsw.edu. Au

Background:

Controlled ovarian hyperstimulation (COH) with clomiphene citrate (CC) combined with intrauterine insemination (IUI) is often used as treatment for ovulatory infertility which includes unexplained, male, cervical, endometriosis, and tubal infertility.

Aims:

To review the effectiveness of CC and IUI in ovulatory infertility.

Methods:

Systematic review of pertinent randomised controlled trials (RCT) using the bibliographic databases MEDLINE and EMBASE. References of selected articles identified were hand-searched for additional relevant citations.

Results:

Six published RCT were included in the overall review. meta-analysis demonstrated a higher cycle pregnancy rate (CPR) with CC and IUI compared to timed intercourse in the natural cycle (P< 0.001 and odds ratio = 4.6, 95% CI = 1.9-11.3). Treatment with gonadotrophins and IUI results in a higher CPR compared to CC and IUI (P = 0.005 and odds ratio = 2.9, 95% CI = 1.3-6.2). Further RCT are required comparing CC and IUI with IUI or CC alone before one can make firm conclusions.

Conclusions:

Clomiphene citrate combined with IUI is more effective than timed intercourse in the natural cycle at achieving pregnancy in couples with ovulatory infertility. However, treatment with gonadotrophins and IUI is superior to CC and IUI.

Please click on the required question.

• Q 11. 1 How successful is infertility treatment?
• Q 11. 2 How can we compare infertility treatments?
• Q 11. 3 How can we compare outcomes between different fertility units?
• Q 11. 4 Are treatments for infertility improving?
• Q 11. 5 Is there an increased chance of miscarriage following infertility treatment?
• Q 11. 6 Is there an increased chance of ectopic pregnancy following infertility treatment?
• Q 11. 7 What is a heterotopic pregnancy?
• Q 11. 8 What problems can occur with multiple pregnancy?
• Q 11. 9 What is selective termination of pregnancy?
• Q 11. 10 How can the pregnancy risks following infertility treatment be reduced?
• Q 11. 11 We have had infertility treatment which has been successful. How will our pregnancy be cared for?
• Q 11. 12 If we have infertility treatment, will our baby be healthy?
• Q 11. 13 What are the psychological effects of infertility? information?
• Q 11. 14 Where can I obtain more information?
• Q 11. 15 Support Groups.
  

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