| Intra-uterine insemination versus timed intercourse for cervical hostility in subfertile couples. | |
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MedLine Citation:
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PMID: 16235303 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The postcoital test has poor diagnostic and prognostic characteristics. Nevertheless, some physicians believe it can identify scanty or abnormal mucus that might impair fertility. One way to avoid 'hostile' cervical mucus is intrauterine insemination. With this technique, the physician injects sperm directly into the uterine cavity through a small catheter passed through the cervix; the theory is to bypass the "hostile" cervical mucus. Although most gynaecological societies do not endorse use of intrauterine insemination for hostile cervical mucus, some physicians consider it an effective treatment for women with infertility thought due to cervical mucus problems. OBJECTIVES: The aim of this review was to determine the effectiveness of intrauterine insemination with or without ovarian stimulation in women with cervical hostility who failed to conceive. SEARCH STRATEGY: We searched Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library Issue 2, 2005, MEDLINE (1966 to June 2005), EMBASE (1980 to June 2005), POPLINE (to June 2005) and LILACS (to June 2005). In addition, we contacted experts and searched the reference list of relevant articles and book chapters. SELECTION CRITERIA: We included randomized and quasi-randomized controlled trials comparing intrauterine insemination with intercourse timed at the presumed fertile period. Participants were women with cervical hostility who failed to conceive for at least one year. DATA COLLECTION AND ANALYSIS: We assessed the titles and abstracts of 386 publications and two reviewers independently abstracted data on methods and results from five studies identified for inclusion. The main outcome is pregnancy rate per couple. MAIN RESULTS: We did not pool the outcomes of the included five studies in a meta-analysis due to the methodological quality of the trials and variations in the patient characteristics and interventions. Narrative summaries of the outcomes are provided. Each study was too small for a clinically relevant conclusion. None of the studies provided information on important outcomes such as spontaneous abortion, multiple pregnancies, and ovarian hyperstimulation syndrome. AUTHORS' CONCLUSIONS: There is no evidence from the published studies that intrauterine insemination is an effective treatment for cervical hostility. Given the poor diagnostic and prognostic properties of the postcoital test and the observation that the test has no benefit on pregnancy rates, intrauterine insemination (with or without ovarian stimulation) is unlikely to be a useful treatment for putative problems identified by postcoital testing. |
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Authors:
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F M Helmerhorst; H A A M Van Vliet; T Gornas; M J J Finken; D A Grimes |
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Publication Detail:
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Type: Journal Article; Review Date: 2005-10-19 |
Journal Detail:
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Title: Cochrane database of systematic reviews (Online) Volume: - ISSN: 1469-493X ISO Abbreviation: Cochrane Database Syst Rev Publication Date: 2005 |
Date Detail:
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Created Date: 2005-10-19 Completed Date: 2006-02-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100909747 Medline TA: Cochrane Database Syst Rev Country: England |
Other Details:
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Languages: eng Pagination: CD002809 Citation Subset: IM |
Affiliation:
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Leiden University Medical Center, Gynaecology & Reproductive Medicine, P.O.Box 9600, Leiden, Netherlands NL 2300 RC. F.M.Helmerhorst@LUMC.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers
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blood Cervix Mucus / physiology* Coitus / physiology* Female Humans Infertility / therapy* Insemination, Artificial, Homologous / methods* Luteinizing Hormone / blood Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 9002-67-9/Luteinizing Hormone |
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