What do systematic reviews say?

Gonadotropins with GnRH agonists vs gonadotropins alone

It is very uncertain whether gonadotropins with GnRH agonists changes multiple pregnancy rate per couple compared with gonadotropins alone (very low certainty).

• Agents for ovarian stimulation for intrauterine insemination (IUI) in ovulatory women with infertility 2021 · Cochrane Headline outcomes only
  OR 2.53 [0.82, 7.86]
  2 studies · 264 participants
  Very low

Gonadotropins with GnRH antagonist vs gonadotropins alone

Gonadotropins with GnRH antagonist showed no clear difference in multiple pregnancy rate per couple compared with gonadotropins alone (moderate certainty).

• Agents for ovarian stimulation for intrauterine insemination (IUI) in ovulatory women with infertility 2021 · Cochrane Headline outcomes only
  OR 1.3 [0.74, 2.28]
  10 studies · 2095 participants
  Moderate

Gonadotropins vs anti‐oestrogens

Gonadotropins showed no clear difference in multiple pregnancy rate per couple compared with anti‐oestrogens (low certainty).

• Agents for ovarian stimulation for intrauterine insemination (IUI) in ovulatory women with infertility 2021 · Cochrane Headline outcomes only
  OR 1.58 [0.6, 4.17]
  7 studies · 2139 participants
  Low

Gonadotrophins with anti‐oestrogens vs gonadotropins alone

Gonadotrophins with anti‐oestrogens showed no clear difference in multiple pregnancy rate per couple compared with gonadotropins alone (low certainty).

• Agents for ovarian stimulation for intrauterine insemination (IUI) in ovulatory women with infertility 2021 · Cochrane Headline outcomes only
  OR 3.03 [0.12, 75.06]
  1 study · 230 participants
  Low

Aromatase inhibitors vs gonadotropins alone

It is very uncertain whether aromatase inhibitors changes multiple pregnancy rate per couple compared with gonadotropins (very low certainty).

• Agents for ovarian stimulation for intrauterine insemination (IUI) in ovulatory women with infertility 2021 · Cochrane Headline outcomes only
  OR 0.69 [0.06, 8.17]
  3 studies · 731 participants
  Very low

Aromatase inhibitors with gonadotropins vs anti‐oestrogens with gonadotropins

Aromatase inhibitors with gonadotropins showed no clear difference in multiple pregnancy rate per couple compared with anti‐oestrogens with gonadotropins (low certainty).

• Agents for ovarian stimulation for intrauterine insemination (IUI) in ovulatory women with infertility 2021 · Cochrane Headline outcomes only
  OR 1.31 [0.39, 4.37]
  4 studies · 901 participants
  Low

Aromatase inhibitors vs anti‐oestrogens

Aromatase inhibitors showed no clear difference in multiple pregnancy rate per couple compared with anti‐oestrogens (low certainty).

• Agents for ovarian stimulation for intrauterine insemination (IUI) in ovulatory women with infertility 2021 · Cochrane Headline outcomes only
  OR 1.28 [0.61, 2.68]
  4 studies · 1000 participants
  Low

Gradient technique vs wash and centrifugation

It is very uncertain whether gradient technique changes multiple pregnancy rate per couple compared with wash and centrifugation (very low certainty).

• Semen preparation techniques for intrauterine insemination 2019 · Cochrane Headline outcomes only
  OR 0.33 [0.01, 8.83]
  1 study · 31 participants
  Very low

Swim‐up technique vs gradient technique

• Semen preparation techniques for intrauterine insemination 2019 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 25 participants
  Very low

Swim‐up technique vs wash and centrifugation

It is very uncertain whether swim‐up technique changes multiple pregnancy rate per couple compared with wash and centrifugation (very low certainty).

• Semen preparation techniques for intrauterine insemination 2019 · Cochrane Headline outcomes only
  OR 0.49 [0.02, 13.28]
  1 study · 26 participants
  Very low

hCG vs GnRH agonist

It is very uncertain whether hCG changes multiple pregnancy rate per pregnancy compared with gnRH‐a (very low certainty).

• Synchronised approach for intrauterine insemination in subfertile couples 2014 · Cochrane Headline outcomes only
  OR 0.15 [0.02, 1.38]
  4 studies · 74 participants
  Very low

hCG vs LH surge

It is very uncertain whether hCG changes multiple pregnancy rate per pregnancy compared with LH surge (very low certainty).

• Synchronised approach for intrauterine insemination in subfertile couples 2014 · Cochrane Headline outcomes only
  OR 1.12 [0.17, 7.6]
  2 studies · 42 participants
  Very low

u‐hCG vs r‐hCG

u‐hCG showed no clear difference in multiple pregnancy rate per pregnancy compared with r‐hCG (low certainty).

• Synchronised approach for intrauterine insemination in subfertile couples 2014 · Cochrane Headline outcomes only
  OR 0.99 [0.4, 2.47]
  2 studies · 109 participants
  Low

Metformin vs placebo co‐treatment

Metformin showed no clear difference in multiple pregnancy rate (per woman) compared with placebo co‐treatment (low certainty).

• Metformin during ovulation induction with gonadotrophins followed by timed intercourse or intrauterine insemination… 2017 · Cochrane Headline outcomes only
  OR 0.55 [0.15, 1.95]
  4 studies · 232 participants
  Low