Answer from: Patricio Calamera, MD, MSc, ObGyn
Well actually IUI is not used anymore for unexplained infertility. Well, I may be criticized by this but honestly I myself don’t do any more IUIs on unexplained infertility because unexplained infertility is a couple that can conceive and they have all of their tests and studies correct so, going through IUI it’s like trying at home and they’ve been trying at home for at least a year so for me it’s not a choice, a logical choice. I will go through an IVF protocol because it’s a higher success rate, a really much higher success rate and it can also bring some light to the cost of this unexplained infertility.
Answer from: Jane Stewart, MD
Over the years people have used IUI quite a lot for so called unexplained subfertility on the basis that if you can prep sperm and put it into the uterus where the egg is, perhaps that gets around some of the problems and there are some really keen advocates for IUI. Historically the trials that were done weren’t great and didn’t really show benefit for lot’s of reasons or didn’t really add up to the use of IUI because there weren’t great trials with proper controls where people weren’t having any treatment at all, there weren’t great trials where people weren’t taking big risks with multiple pregnancy having induced ovulation and perhaps enhanced chances by having and extra egg around. Those trials didn’t really help us in a great way but IUI developed before IVF, it was a way of treating and doing something for people and some people did absolutely get pregnant. Whether they would have anyway is the real debate. There is a good study that was undertaken in Aberdeen looking at unexplained subfertility, where they did a trial, a randomised trial where they looked at couples with a number of treatments, one of which was IUI, but importantly, against no treatment and the equivalent number of people got pregnant in both parts. In other words, the natural cycle IUI did not show benefits. There have been some European studies suggesting benefit but they treated people quite early on in the process and my view is to keep out of hospital and out of peoples houses and maximise your chances as much as possible. So i think it’s not so that it is not successful, some people will get pregnant with IUI but the evidence for benefit depends on who you
listen to and what the criteria is.
Is IUI effective for unexplained infertility?
Who Can IUI Help? Usually IUI is suggested as the first line of treatment for patients who were diagnosed with conditions like endometriosis, mild male factor and also for those labeled with unexpected infertility. When can IUI help patients? If the patient was not able to conceive with the help of ovulation-inducing fertility medication.
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