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IUI in Spontaneous Cycles Proves More Cost Effective.

Intrauterine insemination during spontaneous ovulation cycles should be considered the first-line treatment for couples with idiopathic or male subfertility, according to researchers from the Netherlands.

In a trial involving 248 couples with idiopathic or male subfertility, Dr. Angelique J. Goverde of Vrije Universiteit Medical Center, Amsterdam, and associates found that roughly one-third of the couples ultimately had at least a single live birth regardless of the type of infertility treatment used (Lancet 355[9197]:13-18, 2000).

The couples in the study were randomly assigned to undergo up to six cycles of intrauterine insemination (IUI) during spontaneous cycles, IUI with stimulated cycles, or in vitro fertilization (IVF).

Of the 80 couples who started IUI with spontaneous cycles, 31% were delivered. Similarly 37% of the 83 couples who started IUI with stimulated cycles were delivered, and 38% of the 85 couples who started IVF were delivered.

The multiple pregnancy rate was 29% of all viable pregnancies in the IUI plus stimulation group, 21% in the IVF group, and only 4% in the group who underwent IUI in spontaneous cycles.

The pregnancy rate per initiated treatment cycle was 7.4% for IUI alone, 8.7% for IUI with stimulated cycles, and 12.2% for IVF.

Birth rates following IVF were lower than usual because of a greater tendency for couples assigned to the IVF group to drop out of the study, Dr. Goverde and her associates said.

The cost per pregnancy resulting in a live birth was $4,040 for IUI alone, $5,110 for IUI with stimulated cycles, and $13,130 for IVF.

"Although IVF is more effective on a per cycle basis, IUI in spontaneous cycles is a safer and cheaper option with a similar cumulative pregnancy rate," Dr. Siladitya Bhattacharya of the University of Aberdeen commented in a related editorial (Lancet 355[9197]:2, 2000).
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Title Annotation:Intrauterine insemination
Publication:OB GYN News
Date:Apr 1, 2000
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