Cochrane · systematic review · CD011424
Endometrial injury for pregnancy following sexual intercourse or intrauterine insemination
Bui, BN, Lensen, SF, Gibreel, A, et al. · Cochrane Database of Systematic Reviews · 2022 · 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
14
current version
GRADE rated
11
No studies
3
Included studies
NR
No studies 3 · 21.4%Ungraded 0 · 0%Very low 5 · 35.7%Low 6 · 42.9%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 onlyIntentional endometrial injury vs no intervention or a sham procedure for pregnancy following sexual intercourse or intrauterine insemination
Population: infertile women or couples attempting to conceive through sexual intercourse or intrauterine insemination (IUI)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth (primary analysis) Intentional endometrial injury vs no intervention or a sham procedure | RR 1.11 [0.78, 1.59] | 1 study · 210 participants | Low Downgraded: imprecision, indirectness |
Live birth or ongoing pregnancy (sensitivity analysis) Intentional endometrial injury vs no intervention or a sham procedure | RR 1.71 [1.32, 2.21] | 8 studies · 1522 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Clinical pregnancy (primary analysis) Intentional endometrial injury vs no intervention or a sham procedure | no estimate extracted | NR | Low Downgraded: imprecision, indirectness |
Clinical pregnancy (sensitivity analysis) Intentional endometrial injury vs no intervention or a sham procedure | RR 2.02 [1.67, 2.45] | 19 studies · 3184 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Pain during the procedure Intentional endometrial injury vs no intervention or a sham procedure | no estimate extracted | 6 studies · 991 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Different timing of intentional endometrial injury for pregnancy following sexual intercourse or intrauterine insemination (1)
Population: infertile women or couples attempting to conceive through sexual intercourse or intrauterine insemination (IUI)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy: prior cycle vs IUI cycle | no estimate extracted | NR | No studies |
Clinical pregnancy: prior cycle vs IUI cycle (primary analysis) | no estimate extracted | NR | Low Downgraded: risk of bias |
Clinical pregnancy: prior cycle vs IUI cycle (sensitivity analysis) | RR 1.06 [0.76, 1.46] | 4 studies · 410 participants | Very low Downgraded: risk of bias |
Pain during the procedure | no estimate extracted | NR | No studies |
Different timing of intentional endometrial injury for pregnancy following sexual intercourse or intrauterine insemination (2)
Population: infertile women or couples attempting to conceive through sexual intercourse or intrauterine insemination (IUI)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy: early (EFP) vs late (LFP) follicular phase | no estimate extracted | NR | No studies |
Clinical pregnancy: early (EFP) vs late (LFP) follicular phase (primary analysis) | no estimate extracted | NR | Low Downgraded: risk of bias |
Clinical pregnancy: early (EFP) vs late (LFP) follicular phase (sensitivity analysis) | RR 0.78 [0.31, 1.94] | 1 study · 110 participants | Very low Downgraded: risk of bias |
Pain during the procedure (primary analysis) | no estimate extracted | NR | Low Downgraded: risk of bias |
Pain during the procedure (sensitivity analysis) | no estimate extracted | 1 study · 110 participants | Very low Downgraded: risk of bias |
Intentional endometrial injury vs no intervention or a sham procedure for pregnancy following sexual intercourse or intrauterine insemination
Population: infertile women or couples attempting to conceive through sexual intercourse or intrauterine insemination (IUI)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth (primary analysis) Intentional endometrial injury vs no intervention or a sham procedure | RR 1.11 [0.78, 1.59] | 1 study · 210 participants | Low Downgraded: imprecision, indirectness |
Live birth or ongoing pregnancy (sensitivity analysis) Intentional endometrial injury vs no intervention or a sham procedure | RR 1.71 [1.32, 2.21] | 8 studies · 1522 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Clinical pregnancy (primary analysis) Intentional endometrial injury vs no intervention or a sham procedure | no estimate extracted | NR | Low Downgraded: imprecision, indirectness |
Clinical pregnancy (sensitivity analysis) Intentional endometrial injury vs no intervention or a sham procedure | RR 2.02 [1.67, 2.45] | 19 studies · 3184 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Pain during the procedure Intentional endometrial injury vs no intervention or a sham procedure | no estimate extracted | 6 studies · 991 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Higher vs lower degree of intentional endometrial injury for pregnancy following sexual intercourse or intrauterine insemination
Population: infertile women or couples attempting to conceive through sexual intercourse or intrauterine insemination (IUI)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy (primary analysis) Higher vs lower degree of intentional endometrial injury | no estimate extracted | NR | Low Downgraded: indirectness |
Ongoing pregnancy (sensitivity analysis) Higher vs lower degree of intentional endometrial injury | RR 1.29 [0.71, 2.35] | 1 study · 332 participants | Low Downgraded: indirectness |
Clinical pregnancy (primary analysis) Higher vs lower degree of intentional endometrial injury | no estimate extracted | NR | Low Downgraded: indirectness |
Clinical pregnancy (sensitivity analysis) Higher vs lower degree of intentional endometrial injury | RR 1.15 [0.66, 2.01] | 1 study · 332 participants | Low Downgraded: indirectness |
Pain during the procedure ‐ not reported Higher vs lower degree of intentional endometrial injury | no estimate extracted | NR | No studies |
Different timing of intentional endometrial injury for pregnancy following sexual intercourse or intrauterine insemination (1)
Population: infertile women or couples attempting to conceive through sexual intercourse or intrauterine insemination (IUI)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy: prior cycle vs IUI cycle | no estimate extracted | NR | No studies |
Clinical pregnancy: prior cycle vs IUI cycle (primary analysis) | no estimate extracted | NR | Low Downgraded: risk of bias |
Clinical pregnancy: prior cycle vs IUI cycle (sensitivity analysis) | RR 1.06 [0.76, 1.46] | 4 studies · 410 participants | Very low Downgraded: risk of bias |
Pain during the procedure | no estimate extracted | NR | No studies |
Different timing of intentional endometrial injury for pregnancy following sexual intercourse or intrauterine insemination (2)
Population: infertile women or couples attempting to conceive through sexual intercourse or intrauterine insemination (IUI)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy: early (EFP) vs late (LFP) follicular phase | no estimate extracted | NR | No studies |
Clinical pregnancy: early (EFP) vs late (LFP) follicular phase (primary analysis) | no estimate extracted | NR | Low Downgraded: risk of bias |
Clinical pregnancy: early (EFP) vs late (LFP) follicular phase (sensitivity analysis) | RR 0.78 [0.31, 1.94] | 1 study · 110 participants | Very low Downgraded: risk of bias |
Pain during the procedure (primary analysis) | no estimate extracted | NR | Low Downgraded: risk of bias |
Pain during the procedure (sensitivity analysis) | no estimate extracted | 1 study · 110 participants | Very low Downgraded: risk of bias |
Intentional endometrial injury vs. either no intervention or a sham procedure
Population: women trying to get pregnant from intercourse or intrauterine insemination (IUI)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy Intentional endometrial injury vs either no intervention or a sham procedure | RR 2.22 [1.56, 3.15] | 6 studies · 950 participants | Very low Downgraded: risk of bias, imprecision |
Live birth or ongoing pregnancy ‐ sensitivity Intentional endometrial injury vs either no intervention or a sham procedure | RR 2.64 [1.03, 6.82] | 1 study · 105 participants | Very low Downgraded: imprecision, indirectness |
Pain during the procedure Intentional endometrial injury vs either no intervention or a sham procedure | no estimate extracted | 1 study · 1 participants | Ungraded |
Clinical pregnancy Intentional endometrial injury vs either no intervention or a sham procedure | RR 1.98 [1.51, 2.58] | 8 studies · 1180 participants | Low Downgraded: risk of bias |
Higher vs. lower degree of intentional endometrial injury
Population: women trying to get pregnant from intercourse or intrauterine insemination (IUI)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy Higher vs lower degree of intentional endometrial injury | RR 1.29 [0.71, 2.35] | 1 study · 332 participants | Low Downgraded: imprecision, indirectness |
Pain during the procedure Higher vs lower degree of intentional endometrial injury | no estimate extracted | 0 studies · 0 participants | Ungraded |
Clinical pregnancy Higher vs lower degree of intentional endometrial injury | RR 1.15 [0.66, 2.01] | 1 study · 332 participants | Low Downgraded: imprecision, indirectness |
Different timing of intentional endometrial injury
Population: women trying to get pregnant from intercourse or intrauterine insemination (IUI)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy | RR 0.65 [0.37, 1.16] | 1 study · 176 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pain during the procedure | no estimate extracted | 0 studies · 0 participants | Ungraded |
Clinical pregnancy | RR 0.82 [0.5, 1.36] | 2 studies · 276 participants | Very low Downgraded: risk of bias, imprecision, indirectness |