New University of Auckland research has found couples may not need to undergo invasive and expensive IVF to get pregnant, with other less-invasive procedures proving more effective.
The study, which compared intrauterine insemination with expectant management for women with no reason for their infertility, has been published in the prestigious journal The Lancet.
Lead author Professor Cindy Farquhar of the University's Department of Obstetrics and Gynaecology, says the research found intrauterine insemination (IUI) combined with clomiphene, a medication used to treat women who did not ovulate, was three times more effective than continuing to try to get pregnant without treatment.
Although intrauterine insemination is often offered to couples with unexplained infertility, until now there have been no studies to show benefit.
IUI is a form of fertility treatment in which sperm are injected directly into the uterus. The procedure was less invasive and cheaper than in vitro fertilisation (IVF). One cycle of IVF has about the same effectiveness of three or four IUI cycles.
A total of 201 couples were involved in the study between March 2013 and May 2016. Half continued to try and get pregnant naturally, while the others were given up to three IUI cycles. In total, the IUI group had 31 live births, compared to nine in the other group.
Professor Farquhar says the results offer hope to couples trying to conceive. It is a simpler, gentler treatment than IVF.
"This is the first clinical trial of intrauterine insemination with clomiphene citrate to show benefit. Previous studies either did not use ovarian stimulation or did not include women who were truly infertile," Professor Farquhar says.
Around 40 percent of infertile couples have unexplained infertility, which means they have no obvious explanation for their delay in conceiving.
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Cynthia M Farquhar et al. Intrauterine insemination with ovarian stimulation versus expectant management for unexplained infertility (TUI): a pragmatic, open-label, randomised, controlled, two-centre trial, The Lancet (2017). DOI: 10.1016/S0140-6736(17)32406-6