Clomifene Citrate vs. Intrauterine Insemination for Unexplained Infertility
Author Information
Author(s): Bhattacharya S, Harrild K, Mollison J, Wordsworth S, Tay C, Harrold A, McQueen D, Lyall H, Johnston L, Burrage J, Grossett S, Walton H, Lynch J, Johnstone A, Kini S, Raja A, Templeton A
Primary Institution: Department of Obstetrics and Gynaecology, University of Aberdeen
Hypothesis
Is clomifene citrate or unstimulated intrauterine insemination more effective than expectant management for unexplained infertility?
Conclusion
Clomifene citrate and unstimulated intrauterine insemination do not significantly improve live birth rates compared to expectant management in couples with unexplained infertility.
Supporting Evidence
- Live birth rates were 17% for expectant management, 14% for clomifene citrate, and 23% for intrauterine insemination.
- Women found clomifene citrate and intrauterine insemination more acceptable than expectant management.
- The study included 580 couples, exceeding the recruitment target with less than 1% loss to follow-up.
Takeaway
This study looked at whether two common treatments for infertility help couples have babies better than just waiting. It found that the treatments didn't really work better than doing nothing.
Methodology
A three-arm parallel group, pragmatic randomised controlled trial conducted in four teaching hospitals and one district general hospital in Scotland.
Potential Biases
The presence of mild male factor infertility and minimal endometriosis may introduce clinical heterogeneity.
Limitations
The trial may not be generalizable to other populations and did not address the combined approach of clomifene citrate and intrauterine insemination.
Participant Demographics
Couples with over two years of infertility, confirmed ovulation, patent fallopian tubes, and motile sperm.
Statistical Information
P-Value
0.001
Confidence Interval
0.45 to 1.38 for clomifene citrate; 0.88 to 2.43 for intrauterine insemination
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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