Cochrane · systematic review · CD003357
In vitro fertilisation for unexplained subfertility
Sunkara, SK, Kamath, MS, Pandian, Z, et al. · Cochrane Database of Systematic Reviews · 2023 · 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
15
current version
GRADE rated
11
No studies
4
Included studies
NR
No studies 4 · 26.7%Ungraded 0 · 0%Very low 7 · 46.7%Low 4 · 26.7%Moderate 0 · 0%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 onlyIVF versus expectant management for unexplained subfertility
Population: women with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth per woman randomised IVF vs expectant management | OR 22 [2.56, 189.37] | 1 study · 51 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Clinical pregnancy rate per woman randomised IVF vs expectant management | OR 3.24 [1.07, 9.8] | 2 studies · 86 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Multiple pregnancy rate per woman randomised IVF vs expectant management | no estimate extracted | NR | No studies |
OHSS rate per woman randomised IVF vs expectant management | no estimate extracted | NR | No studies |
Miscarriage rate per woman randomised IVF vs expectant management | no estimate extracted | NR | No studies |
IVF versus unstimulated IUI for unexplained subfertility
Population: women with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per woman randomised IVF vs unstimulated IUI | OR 2.47 [1.19, 5.12] | 2 studies · 156 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Clinical pregnancy rate per woman randomised IVF vs unstimulated IUI | OR 4.83 [0.94, 24.95] | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Multiple pregnancy rate per woman randomised IVF vs unstimulated IUI | OR 1.03 [0.04, 27.29] | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
OHSS rate per woman randomised IVF vs unstimulated IUI | no estimate extracted | NR | No studies |
Miscarriage rate per woman randomised IVF vs unstimulated IUI | OR 1.72 [0.14, 21.25] | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
IVF versus IUI + ovarian stimulation with gonadotropins or CC for unexplained subfertility
Population: women with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per woman randomised IVF vs IUI + ovarian stimulation with gonadotropins or CC | OR 1.19 [0.87, 1.61] | 3 studies · 731 participants | Low Downgraded: risk of bias, imprecision |
Clinical pregnancy rate per woman randomised IVF vs IUI + ovarian stimulation with gonadotropins or CC | OR 1.17 [0.85, 1.59] | 3 studies · 731 participants | Low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate per woman randomised IVF vs IUI + ovarian stimulation with gonadotropins or CC | OR 0.82 [0.38, 1.77] | 3 studies · 731 participants | Low Downgraded: risk of bias, imprecision |
OHSS rate per woman randomised IVF vs IUI + ovarian stimulation with gonadotropins or CC | OR 6.86 [0.35, 134.59] | 1 study · 207 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Miscarriage rate per woman randomised IVF vs IUI + ovarian stimulation with gonadotropins or CC | OR 0.31 [0.03, 3.04] | 1 study · 207 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
IVF compared with expectant management for unexplained subfertility
Population: women with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per woman IVF vs expectant management IVF vs expectant management | OR 22 [2.56, 189.37] | 1 study · 51 participants | Very low Downgraded: imprecision, inconsistency, indirectness |
Pregnancy rate per woman IVF vs expectant management IVF vs expectant management | OR 3.24 [1.07, 9.8] | 2 studies · 86 participants | Very low Downgraded: imprecision, inconsistency, indirectness |
Multiple pregnancy rate IVF vs expectant management | no estimate extracted | NR | No studies |
IVF compared with unstimulated IUI for unexplained subfertility
Population: women with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate IVF vs IUI IVF vs unstimulated IUI | OR 2.47 [1.19, 5.12] | 2 studies · 156 participants | Low Downgraded: imprecision, inconsistency |
Pregnancy rate IVF vs IUI IVF vs unstimulated IUI | OR 4.83 [0.94, 24.95] | 1 study · 43 participants | Very low Downgraded: imprecision |
Multiple pregnancy rate IVF vs unstimulated IUI | OR 1.03 [0.04, 27.29] | 1 study · 43 participants | Very low Downgraded: imprecision, inconsistency |
IVF compared with IUI + superovulation for unexplained subfertility
Population: women with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate in treatment‐naive women IVF vs IUI + gonadotropins IVF vs IUI + superovulation | OR 1.27 [0.94, 1.73] | 4 studies · 745 participants | Moderate Downgraded: imprecision |
Live birth rate in pretreated women IVF vs IUI + gonadotropins IVF vs IUI + superovulation | OR 3.9 [2.32, 6.57] | 1 study · 280 participants | Moderate Downgraded: imprecision |
Live birth rate in treatment‐naive women IVF vs IUI + CC IVF vs IUI + superovulation | OR 2.51 [0.96, 6.55] | 1 study · 103 participants | Low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate IVF vs IUI + superovulation | OR 0.81 [0.47, 1.39] | 4 studies · 848 participants | Moderate Downgraded: risk of bias, imprecision |
Incidence of OHSS IVF vs IUI + superovulation | OR 1.15 [0.43, 3.06] | 2 studies · 324 participants | Low Downgraded: risk of bias, imprecision |
IVF versus expectant management for unexplained subfertility
Population: patients with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per woman IVF vs expectant management | OR 22 [2.56, 189.37] | 1 study · 51 participants | Low |
IVF versus IUI for unexplained subfertility
Population: patients with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per woman IVF vs IUI | OR 1.96 [0.88, 4.36] | 1 study · 113 participants | Very low Downgraded: imprecision |
IVF versus IUI + ovarian stimulation for unexplained subfertility
Population: patients with unexplained subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per woman IVF vs IUI + ovarian stimulation | no estimate extracted | 3 studies · 1150 participants | Low Downgraded: inconsistency |