Intrauterine insemination

被引：180

作者：

Aboulghar, M. ^{[2
]}

Baird, D. T. ^{[3
]}

Collins, J. ^{[4
]}

Evers, J. L. H. ^{[5
]}

Fauser, B. C. J. M. ^{[6
]}

Lambalk, C. B. ^{[7
]}

Somigliana, E. ^{[1
]}

Sunde, A. ^{[8
]}

Tarlatzis, B. ^{[9
]}

Crosignani, P. G. ^{[1
]}

Devroey, P. ^{[10
]}

Diczfalusy, E. ^{[11
]}

Diedrich, K. ^{[12
]}

Fraser, L. ^{[13
]}

Geraedts, J. P. M. ^{[14
]}

Gianaroli, L. ^{[15
]}

Glasier, A. ^{[16
]}

Van Steirteghem, A. ^{[10
]}

机构：

[1] Fondazione Osped Maggiore Policlin, Infertil Unit, I-20122 Milan, Italy

[2] Cairo Univ, Clin Director, Egyptian IVF ET Ctr, Cairo, Egypt

[3] Univ Edinburgh, Ctr Reprod Biol, Edinburgh EH8 9YL, Midlothian, Scotland

[4] McMaster Univ, Hamilton, ON, Canada

[5] Acad Hosp Maastricht, Dept Obstet & Gynecol, Maastricht, Netherlands

[6] Univ Med Ctr, Dept Reprod Med & Gynecol, Utrecht, Netherlands

[7] Vrije Univ Amsterdam Med Ctr, Dept Obstet & Gynaecol, Div Reprod Med, Amsterdam, Netherlands

[8] Univ Trondheim, Dept Obstet & Gynecol, N-7034 Trondheim, Norway

[9] Infertil & IVF Ctr, Thessaloniki, Greece

[10] Vrije Univ Brussel, Univ Ziekenhuis, Ctr Reprod Med, Brussels, Belgium

[11] Karolinska Inst, Stockholm, Sweden

[12] Univ Klinikum Schleswig Holstein, Klin Frauenheilkunde & Geburtshilfe, Lubeck, Germany

[13] Kings Coll London, Sch Biomed & Hlth Sci, Reprod & Rhythms Grp, London, England

[14] Univ Maastricht, Head Dept Genet & Cell Biol, Maastricht, Netherlands

[15] SISMeR, Bologna, Italy

[16] Family Planning & WW Serv, Edinburgh, Midlothian, Scotland

来源：

HUMAN REPRODUCTION UPDATE | 2009年 / 15卷 / 03期

关键词：

intrauterine insemination; unexplained infertility; male subfertility; multiple pregnancy; mild ovarian stimulation; IN-VITRO FERTILIZATION; CONTROLLED OVARIAN HYPERSTIMULATION; FOLLICLE-STIMULATING-HORMONE; TUBE SPERM PERFUSION; ASSISTED REPRODUCTIVE TECHNOLOGY; HUMAN MENOPAUSAL GONADOTROPIN; HUMAN CHORIONIC-GONADOTROPIN; PROSPECTIVE RANDOMIZED-TRIAL; ORDER MULTIPLE IMPLANTATION; CLOMIPHENE CITRATE;

D O I：

10.1093/humupd/dmp003

中图分类号：

R71 [妇产科学];

学科分类号：

100211 [妇产科学];

摘要：

Intrauterine insemination (IUI) with or without ovarian stimulation is a common treatment for infertility. Despite its popularity, the effectiveness of IUI treatment is not consistent, and the role of IUI and in vitro fertilization (IVF) treatment in practice protocols has not been clarified. Medline searches were done by individual topics (utilization, procedures, effectiveness of partner but not donor IUI and related endocrine issues). Effectiveness of IUI was evaluated in relevant randomized controlled trials, using meta-analysis and meta-regression where necessary. Stimulated IUI is ineffective in male infertility and the effect on other diagnoses is small. With clomiphene citrate and IUI, the most common IUI protocol, pregnancy rates average 7% per cycle. FSH ovarian stimulation and IUI treatment is only modestly better than observation only with pregnancy rate 12% per cycle but multiple birth rates averaging 13%. Mildly stimulated (1-2 follicles) cycles might reduce the cost and multiple birth rates but may require more cycles of treatment. Prevention of premature luteinizing hormone surges and luteal phase support do not appear to be major requirements in IUI cycles. IUI treatment requires ovarian stimulation to achieve modest results, but the high multiple pregnancy rates mean that it is no more than a poor substitute for IVF treatment. More trials are needed on IUI treatment with mild stimulation and on the order of IUI and other treatments.

引用

页码：265 / 277

页数：13

共 113 条

[1]

Pregnancy outcome following exposure to gonadotrophin-releasing hormone analogue during early pregnancy: Comparisons in patients with normal or elevated luteinizing hormone [J].