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Archives of Gynecology and Obstetrics

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12.10.2021 | Review

Intrauterine insemination + controlled ovarian hyperstimulation versus in vitro fertilisation in unexplained infertility: a systematic review and meta-analysis

verfasst von: Anupa Nandi, Gangopadhyay Raja, Davinia White, El-Toukhy Tarek

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2022

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Abstract

Background

IUI + COH is widely used in cases of unexplained infertility before resorting to IVF. Debate continues about what should be the first-line treatment for couples with unexplained infertility.

Objectives

This systematic review assessed the relative efficacy of IUI + COH compared with IVF in couples with unexplained infertility.

Search strategy

We searched Medline, Embase, CIHNL, Pscy Info, and Cochrane Library from 1980 to November 2019.

Selection criteria

Only RCTs published articles in full text with female patients aged 18–43 years and diagnosed with unexplained infertility were included.

Data collection and analysis

Two authors reviewed citations from primary search independently and any disagreement was resolved by mutual discussion and consultation with a third author.

Main result

In total, eight RCTs were included. The quality of evidence was moderate to low due to inconsistency across the trials and imprecision. The pooled result showed that IVF was associated with a statistically significant higher live birth rate (RR 1.53, 95% CI 1.01–2.32, P < 0.00001 I² = 86%) with no significant difference in multiple pregnancy rate or OHSS rate. Sensitivity analysis based on women’s age and a history of previous IUI or IVF treatment showed no significant difference in the live birth rates (RR 1.01, 95% CI 0.88–1.15, I² = 0%, 3 RCTs) in treatment-naïve women younger than 38 years. In women over 38 years, the live birth rates were significantly higher in the IVF group (RR 2.15, 95% CI 1.16–4.0, I² = 42%, 1 RCT).

Conclusion

Further research using a standardised treatment protocol and taking into account important prognostic variables and cumulative live birth rates from fresh IVF and all sibling frozen embryos is required to further guide clinical practice.

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Titel: Intrauterine insemination + controlled ovarian hyperstimulation versus in vitro fertilisation in unexplained infertility: a systematic review and meta-analysis
verfasst von: Anupa Nandi
Gangopadhyay Raja
Davinia White
El-Toukhy Tarek
Publikationsdatum: 12.10.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 4/2022
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-021-06277-3

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Intrauterine insemination + controlled ovarian hyperstimulation versus in vitro fertilisation in unexplained infertility: a systematic review and meta-analysis

Abstract

Background

Objectives

Search strategy

Selection criteria

Data collection and analysis

Main result

Conclusion

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Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

Update Gynäkologie

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Background

Objectives

Search strategy

Selection criteria

Data collection and analysis

Main result

Conclusion

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