Cochrane · systematic review · CD001838

Intra‐uterine insemination for unexplained subfertility

Ayeleke, RO, Asseler, JD, Cohlen, BJ, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Gynaecology and Fertility2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
31
current version
GRADE rated
27
No studies
4
Included studies
NR
No studies 4 · 12.9%Ungraded 0 · 0%Very low 2 · 6.5%Low 20 · 64.5%Moderate 5 · 16.1%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

IUI in a natural cycle compared to TI or expectant management in a natural cycle for unexplained subfertility

Population: participants with unexplained subfertility
6 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rates per couple (all cycles)
IUI in a natural cycle vs TI or expectant management
OR 1.6 [0.92, 2.78]1 study · 334 participantsLow
Downgraded: imprecision
Multiple pregnancy rate per couple
IUI in a natural cycle vs TI or expectant management
OR 0.5 [0.04, 5.53]1 study · 334 participantsLow
Downgraded: imprecision
Pregnancy rate per couple (all cycles)
IUI in a natural cycle vs TI or expectant management
OR 1.53 [0.88, 2.64]1 study · 334 participantsLow
Downgraded: imprecision
Ovarian hyperstimulation syndrome rate per woman ‐ not reported
IUI in a natural cycle vs TI or expectant management
no estimate extractedNRNo studies
Miscarriage rate per couple
IUI in a natural cycle vs TI or expectant management
OR 0.77 [0.28, 2.11]1 study · 334 participantsLow
Downgraded: imprecision
Ectopic pregnancy rate per couple
IUI in a natural cycle vs TI or expectant management
OR 5.06 [0.24, 1106.21]1 study · 334 participantsLow
Downgraded: imprecision

IUI in a stimulated cycle compared to TI or expectant management in a stimulated cycle for unexplained subfertility

Population: participants with unexplained subfertility
6 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate per couple (all cycles)
IUI in a stimulated cycle vs TI or expectant management
OR 1.59 [0.88, 2.88]2 studies · 208 participantsLow
Downgraded: imprecision
Multiple pregnancy rate per couple
IUI in a stimulated cycle vs TI or expectant management
OR 1.46 [0.55, 3.87]4 studies · 316 participantsLow
Downgraded: imprecision
Pregnancy rate per couple (all cycles)
IUI in a stimulated cycle vs TI or expectant management
OR 1.69 [1.14, 2.53]6 studies · 517 participantsLow
Downgraded: risk of bias, imprecision
Ovarian hyperstimulation syndrome rate per woman
IUI in a stimulated cycle vs TI or expectant management
OR 2.75 [0.11, 69.83]1 study · 68 participantsVery low
Downgraded: risk of bias, imprecision
Miscarriage rate per couple
IUI in a stimulated cycle vs TI or expectant management
OR 1.66 [0.56, 4.88]2 studies · 208 participantsLow
Downgraded: imprecision
Ectopic pregnancy rate per couple
IUI in a stimulated cycle vs TI or expectant management
OR 3.06 [0.12, 76.95]1 study · 100 participantsLow
Downgraded: imprecision

IUI in a stimulated cycle compared to TI or expectant management in a natural cycle for unexplained subfertility

Population: participants with unexplained subfertility
7 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate per couple (all cycles)‐ clomiphene citrate or letrozole
IUI in a stimulated cycle vs TI or expectant management
OR 4.48 [2, 10.01]1 study · 201 participantsModerate
Downgraded: imprecision
Live birth rate per couple (all cycles)‐ clomiphene citrate or gonadotropins
IUI in a stimulated cycle vs TI or expectant management
OR 0.82 [0.45, 1.49]1 study · 253 participantsLow
Downgraded: imprecision
Multiple pregnancy rate per couple
IUI in a stimulated cycle vs TI or expectant management
OR 3.01 [0.47, 19.28]2 studies · 454 participantsLow
Downgraded: imprecision
Pregnancy rate per couple (all cycles)‐ clomiphene citrate or letrozole
IUI in a stimulated cycle vs TI or expectant management
OR 4.68 [2.22, 9.86]1 study · 201 participantsModerate
Downgraded: imprecision
Ovarian hyperstimulation syndrome rate per woman
IUI in a stimulated cycle vs TI or expectant management
no estimate extractedNRNo studies
Miscarriage rate per couple
IUI in a stimulated cycle vs TI or expectant management
OR 2.87 [1.18, 7.01]2 studies · 454 participantsModerate
Downgraded: imprecision
Ectopic pregnancy rate per couple
IUI in a stimulated cycle vs TI or expectant management
OR 9.28 [0.49, 174.6]1 study · 201 participantsLow
Downgraded: imprecision

IUI in a natural cycle compared to TI or expectant management in a stimulated cycle for unexplained subfertility

Population: participants with unexplained subfertility
6 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate per couple (all cycles)
IUI in a natural cycle vs TI or expectant management
OR 1.95 [1.1, 3.44]1 study · 342 participantsModerate
Downgraded: imprecision
Multiple pregnancy rate per couple
IUI in a natural cycle vs TI or expectant management
OR 1.05 [0.07, 16.9]1 study · 342 participantsLow
Downgraded: imprecision
Pregnancy rate per couple (all cycles)
IUI in a natural cycle vs TI or expectant management
OR 1.77 [1.01, 3.08]1 study · 342 participantsModerate
Downgraded: imprecision
Ovarian hyperstimulation syndrome rate per woman ‐ not reported
IUI in a natural cycle vs TI or expectant management
no estimate extractedNRNo studies
Miscarriage rater per couple
IUI in a natural cycle vs TI or expectant management
OR 0.91 [0.32, 2.58]1 study · 342 participantsLow
Downgraded: imprecision
Ectopic pregnancy rate per couple
IUI in a natural cycle vs TI or expectant management
OR 5.3 [0.25, 111.26]1 study · 342 participantsLow
Downgraded: imprecision

IUI in a stimulated cycle compared to IUI in a natural cycle for unexplained subfertility

Population: participants with unexplained subfertility
6 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rare per couple (all cycles)
IUI in a stimulated cycle vs IUI
OR 2.07 [1.22, 3.5]4 studies · 396 participantsLow
Downgraded: risk of bias, imprecision
Multiple pregnancy rate per couple
IUI in a stimulated cycle vs IUI
OR 3 [0.11, 78.27]1 study · 39 participantsLow
Downgraded: imprecision
Pregnancy rate per couple (all cycles)
IUI in a stimulated cycle vs IUI
OR 6.43 [0.56, 73.35]1 study · 26 participantsLow
Downgraded: imprecision
Ovarian hyperstimulation syndrome rate per woman ‐ not measured
IUI in a stimulated cycle vs IUI
no estimate extractedNRNo studies
Miscarriage rate per couple
IUI in a stimulated cycle vs IUI
OR 5.21 [0.19, 141.08]1 study · 26 participantsLow
Downgraded: imprecision
Ectopic pregnancy rate per couple
IUI in a stimulated cycle vs IUI
OR 6.48 [0.33, 127.09]1 study · 211 participantsVery low
Downgraded: risk of bias, imprecision