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Intervention Not Effective for Some Subfertile Couples

No effect seen from intrauterine insemination with controlled ovarian hyperstimulation

MONDAY, July 17 (HealthDay News) -- In couples with unexplained subfertility and an intermediate probability of a spontaneous ongoing pregnancy, the first-line treatment of intrauterine insemination with controlled ovarian hyperstimulation is no more effective than expectant management, according to a study in the July 15 issue of The Lancet.

Pieternel Steures, M.D., of the Academic Medical Centre and Vrije Universiteit Medical Centre in Amsterdam, the Netherlands, and colleagues randomly assigned 253 couples with a 30 percent to 40 percent probability of a spontaneous ongoing pregnancy within 12 months to either intrauterine insemination with controlled ovarian hyperstimulation or expectant management for six months.

The researchers found that 42 (33 percent) of women in the intervention group conceived and that 29 (23 percent) achieved ongoing pregnancies. They found that 40 (32 percent) of women in the expectant management group conceived and that 34 (27 percent) achieved ongoing pregnancies. They observed one twin pregnancy in each study group and one triplet pregnancy in the intervention group.

"Our study shows that identification of couples who will not benefit from intrauterine insemination is possible," the authors conclude. "Through selection of these couples, the misuse of facilities and other resources can be avoided. Our trial also emphasizes the importance of expectant management, which is an efficient way to prevent multiple pregnancy."

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