| Is in vitro fertilisation more effective than stimulated intrauterine insemination as a first-line therapy for subfertility? A cohort analysis. | |
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MedLine Citation:
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PMID: 20618248 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare a strategy of two cycles of intrauterine insemination with controlled ovarian hyperstimulation (IUI/COH) vs one in vitro fertilisation (IVF) treatment programme (one fresh plus associated frozen embryo cycles) in couples presenting with unexplained, mild male or mild female subfertility. METHODS: A retrospective cohort design was used and analysed according to intention-to-treat principles. A total of 272 couples underwent an intended course of two cycles of IUI/COH and 176 couples underwent one IVF treatment programme. RESULTS: The cumulative live birth rate (CLBR) per couple for the IUI/COH group was 27.6% compared to 39.2% for the IVF group (P = 0.01). The mean time to pregnancy was 69 days in the IUI/COH group compared to 44 days in the IVF group (P = 0.02). The IVF programme was costlier, with an incremental cost-effectiveness ratio for an additional live birth in the range of $39,637-$46,325. The multiple delivery rate was 13.3% in the IUI/COH group compared to 10.1% in the IVF group (P = 0.55). One set of triplets and one set of quadruplets followed IUI/COH treatment. CONCLUSIONS: One IVF treatment programme was more effective, but costlier than an intended course of two cycles of IUI/COH. With consistently higher success rates, shorter times to pregnancy and a trend to less higher order multiple pregnancies, this study supports the view that IVF is now potentially safer and more clinically effective than IUI/COH as a first-line therapy for subfertility. |
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Authors:
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Georgina M Chambers; Elizabeth A Sullivan; Marian Shanahan; Maria T Ho; Katelyn Priester; Michael G Chapman |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Australian & New Zealand journal of obstetrics & gynaecology Volume: 50 ISSN: 1479-828X ISO Abbreviation: Aust N Z J Obstet Gynaecol Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-07-12 Completed Date: 2010-09-29 Revised Date: 2010-12-21 |
Medline Journal Info:
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Nlm Unique ID: 0001027 Medline TA: Aust N Z J Obstet Gynaecol Country: Australia |
Other Details:
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Languages: eng Pagination: 280-8 Citation Subset: IM |
Affiliation:
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Perinatal and Reproductive Epidemiology Research Unit, School Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia. g.chambers@unsw.edu.au |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Birth Rate Cohort Studies Cost-Benefit Analysis Female Fertilization in Vitro* / economics Humans Infertility / therapy* Insemination, Artificial* / economics Male Ovulation Induction / economics Pregnancy Retrospective Studies |
| Comments/Corrections | |
Comment In:
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Aust N Z J Obstet Gynaecol. 2010 Dec;50(6):583; author reply 583-4
[PMID:
21133878
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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