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
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
Current version onlyIUI in a natural cycle compared to TI or expectant management in a natural cycle for unexplained subfertility
Population: participants with unexplained subfertility
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Low 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 participants | Low Downgraded: imprecision |
Ovarian hyperstimulation syndrome rate per woman ‐ not reported IUI in a natural cycle vs TI or expectant management | no estimate extracted | NR | No 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 participants | Low 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 participants | Low 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
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Low 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 participants | Low 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 participants | Very 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 participants | Low 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 participants | Low 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
| Outcome | Effect | Evidence | Status / 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 participants | Moderate 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 participants | Low 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 participants | Low 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 participants | Moderate Downgraded: imprecision |
Ovarian hyperstimulation syndrome rate per woman IUI in a stimulated cycle vs TI or expectant management | no estimate extracted | NR | No 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 participants | Moderate 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 participants | Low 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
| Outcome | Effect | Evidence | Status / 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 participants | Moderate 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 participants | Low 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 participants | Moderate Downgraded: imprecision |
Ovarian hyperstimulation syndrome rate per woman ‐ not reported IUI in a natural cycle vs TI or expectant management | no estimate extracted | NR | No 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 participants | Low 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 participants | Low Downgraded: imprecision |
IUI in a stimulated cycle compared to IUI in a natural cycle for unexplained subfertility
Population: participants with unexplained subfertility
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Low 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 participants | Low Downgraded: imprecision |
Ovarian hyperstimulation syndrome rate per woman ‐ not measured IUI in a stimulated cycle vs IUI | no estimate extracted | NR | No studies |
Miscarriage rate per couple IUI in a stimulated cycle vs IUI | OR 5.21 [0.19, 141.08] | 1 study · 26 participants | Low Downgraded: imprecision |
Ectopic pregnancy rate per couple IUI in a stimulated cycle vs IUI | OR 6.48 [0.33, 127.09] | 1 study · 211 participants | Very low Downgraded: risk of bias, imprecision |
IUI compared to TI or expectant management both in natural cycle for unexplained subfertility
Population: people with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per couple (all cycles) IUI vs TI or expectant management both | OR 1.6 [0.92, 2.78] | 1 study · 334 participants | Moderate Downgraded: imprecision |
Multiple pregnancy rate per couple IUI vs TI or expectant management both | OR 0.5 [0.04, 5.53] | 1 study · 334 participants | Moderate Downgraded: imprecision |
Pregnancy rate per couple (all cycles) IUI vs TI or expectant management both | OR 1.53 [0.88, 2.64] | 1 study · 334 participants | Moderate Downgraded: imprecision |
Ovarian Hyperstimulation Syndrome rate per woman ‐ not reported IUI vs TI or expectant management both | no estimate extracted | NR | No studies |
Miscarriage rate per couple IUI vs TI or expectant management both | OR 0.77 [0.28, 2.11] | 1 study · 334 participants | Moderate Downgraded: imprecision |
Ectopic pregnancy rate per couple IUI vs TI or expectant management both | OR 5.06 [0.24, 106.2] | 1 study · 334 participants | Moderate Downgraded: imprecision |
IUI compared to TI or expectant management both in stimulated cycle for unexplained subfertility
Population: people with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per couple (all cycles) IUI vs TI or expectant management both | OR 1.59 [0.88, 2.88] | 2 studies · 208 participants | Moderate Downgraded: imprecision |
Multiple pregnancy rate per couple IUI vs TI or expectant management both | OR 1.46 [0.55, 3.87] | 4 studies · 316 participants | Low Downgraded: risk of bias, imprecision |
Pregnancy rate per couple (all cycles) IUI vs TI or expectant management both | OR 1.69 [1.14, 2.53] | 7 studies · 517 participants | Low Downgraded: risk of bias, imprecision |
Ovarian Hyperstimulation Syndrome rate per woman IUI vs TI or expectant management both | OR 2.75 [0.11, 69.83] | 1 study · 68 participants | Low Downgraded: risk of bias, imprecision |
Miscarriage rate per couple IUI vs TI or expectant management both | OR 1.66 [0.56, 4.88] | 2 studies · 208 participants | Moderate Downgraded: imprecision |
Ectopic pregnancy rate per couple IUI vs TI or expectant management both | OR 3.06 [0.12, 76.95] | 1 study · 100 participants | Moderate Downgraded: imprecision |
IUI in natural cycle compared to IUI in stimulated cycle for unexplained subfertility
Population: people with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per couple (all cycles) IUI in natural cycle vs IUI | OR 0.48 [0.29, 0.82] | 4 studies · 396 participants | Moderate Downgraded: imprecision |
Multiple pregnancy rate per couple IUI in natural cycle vs IUI | OR 0.33 [0.01, 8.7] | 2 studies · 65 participants | Low Downgraded: imprecision |
Pregnancy rate per couple (all cycles) IUI in natural cycle vs IUI | OR 0.16 [0.01, 1.77] | 1 study · 26 participants | Moderate Downgraded: imprecision |
Ovarian Hyperstimulation Syndrome rate per woman5 ‐ not measured IUI in natural cycle vs IUI | no estimate extracted | NR | No studies |
Miscarriage rate per couple IUI in natural cycle vs IUI | OR 0.19 [0.01, 5.2] | 1 study · 26 participants | Low Downgraded: imprecision |
Ectopic pregnancy rate per couple IUI in natural cycle vs IUI | OR 0.15 [0.01, 3.02] | 2 studies · 250 participants | Moderate Downgraded: imprecision |
IUI in stimulated cycle compared to TI or expectant management in natural cycle for unexplained subfertility
Population: people with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per couple (all cycles) IUI in stimulated cycle vs TI or expectant management | OR 0.82 [0.45, 1.49] | 1 study · 253 participants | Moderate Downgraded: imprecision |
Multiple pregnancy rate per couple IUI in stimulated cycle vs TI or expectant management | OR 2 [0.18, 22.34] | 2 studies · 304 participants | Moderate Downgraded: imprecision |
Pregnancy rate per couple (all cycles) IUI in stimulated cycle vs TI or expectant management | OR 1 [0.59, 1.67] | 2 studies · 304 participants | Moderate Downgraded: imprecision |
Ovarian Hyperstimulation rate per woman ‐ not measured IUI in stimulated cycle vs TI or expectant management | no estimate extracted | NR | No studies |
Miscarriage rate per couple IUI in stimulated cycle vs TI or expectant management | OR 2.28 [0.84, 6.2] | 1 study · 253 participants | Moderate Downgraded: imprecision |
Ectopic pregnancy rate per couple ‐ not reported IUI in stimulated cycle vs TI or expectant management | no estimate extracted | NR | No studies |
IUI in natural cycle compared to TI or expectant management in stimulated cycle for unexplained subfertility
Population: people with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per couple (all cycles) IUI in natural cycle vs TI or expectant management | OR 1.95 [1.1, 3.44] | 1 study · 342 participants | Moderate Downgraded: imprecision |
Multiple pregnancy rate per couple IUI in natural cycle vs TI or expectant management | OR 1.05 [0.07, 16.9] | 1 study · 342 participants | Moderate Downgraded: imprecision |
Pregnancy rate per couple (all cycles) IUI in natural cycle vs TI or expectant management | OR 1.77 [1.01, 3.08] | 1 study · 342 participants | Moderate Downgraded: imprecision |
Ovarian Hyperstimulation Syndrome rate per woman ‐ not reported IUI in natural cycle vs TI or expectant management | no estimate extracted | NR | No studies |
Miscarriage rate per couple IUI in natural cycle vs TI or expectant management | OR 0.91 [0.32, 2.58] | 1 study · 342 participants | Moderate Downgraded: imprecision |
Ectopic pregnancy rate per couple IUI in natural cycle vs TI or expectant management | OR 5.3 [0.25, 111.3] | 1 study · 342 participants | Moderate Downgraded: imprecision |