IUI Is a Valuable and Cost-Effective Therapy for Most Couples
Cost-effectiveness of IUI has been addressed in only few randomized controlled trials. These trials are difficult to compare because they differ in patient characteristics, included costs, and treatment strategies. Despite these differences, current evidence shows that expectant management is the first-line treatment option in couples with a favorable prognosis for natural conception. Follow-up treatment with IUI is more cost-effective than immediate IVF. The duration of treatment with IUI before proceeding to IVF and the additional value of ovarian stimulation are unclear. An important omission in the present studies is the lack of including the costs caused by multiple gestations and the prognostic profile of the included couples. A study is currently being performed in couples with a poor prognosis for natural conception with mild male or unexplained infertility. This study compares six cycles of IUI, three cycles of IVF eSET, or six cycles of modified natural cycle IVF. This study may give the final answer about which strategy is the most cost-effective strategy for couples after expectant management failed.
KeywordsExpense Estradiol Infertility Endometriosis Anovulation
- 2.NCCWCH. Clinical Guideline 11. Fertility: assessment and treatment for peole with fertility problems. 2004. http://www.nice.org.uk.
- 3.RCOG. The management of infertility in secondary care. 1998. http://www.rcog.org.uk.
- 4.Quaas A, Dokras A. Diagnosis and treatment of unexplained infertility. Rev Obstet Gynecol. 2008 Spring;1(2):69–76.Google Scholar
- 6.Steures P, van der Steeg JW, Hompes PG, et al. Intrauterine insemination with controlled ovarian hyperstimulation versus expectant management for couples with unexplained subfertility and an intermediate prognosis: a randomised clinical trial. Lancet. 2006;368(9531):216–21.PubMedCrossRefGoogle Scholar
- 11.Custers IM, Konig TE, Broekmans FJ, et al. Couples with unexplained subfertility and unfavorable prognosis: a randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation. Fertil Steril. 2011;96(5):1107–11.e1.PubMedCrossRefGoogle Scholar