Volume 107, Issue 6, Pages 1329–1335.e2
Anupa Nandi, M.R.C.O.G., Priya Bhide, M.R.C.O.G., Richard Hooper, Ph.D., Anil Gudi, M.R.C.O.G., Amit Shah, M.R.C.O.G., Khalid Khan, Ph.D., Roy Homburg, F.R.C.O.G.
To evaluate the best first line management option for the treatment of unexplained subfertility-controlled ovarian hyperstimulation (COH) with gonadotropins and IUI or IVF.
Randomized controlled trial.
Single center trial in a tertiary referral unit.
Couples with unexplained subfertility.
Couples were randomized to receive either three cycles of IUI + COH or one cycle of IVF.
Main Outcome Measure(s)
Singleton pregnancy rate (PR) per couple.
A total of 207 couples were randomly assigned to three cycles of IUI + COH (n = 101) or one cycle of IVF (n = 106). There were 25 (24.7%) singleton live births for the IUI + COH group and 33 (31.1%) for the IVF group (relative risk, 1.3; 95% confidence interval [CI] 0.81–1.96) with an absolute risk difference of 6.4% (95% CI −5.8% to 18.6%). The multiple pregnancies per live birth were 4 (13.8%) for the IUI + COH group and 3 (8.3%) for the IVF group (relative risk, 0.6; 95% CI 0.14–2.4). There were no cases of ovarian hyperstimulation syndrome (OHSS) in the IUI group and three cases of OHSS (3.7%) in the IVF group. There were 17 live births from spontaneous conception in between treatment cycles (8.2%).
The singleton live birth rate with one cycle of IVF was not significantly different than three cycles of IUI + COH.
Clinical Trial Registration Number