Guzick DS, Sullivan MW, Adamson GD, Cedars MI, Falk RJ, Peterson EP, Steinkampf MP. Efficacy of treatment for unexplained infertility.
Fertil Steril 1998;
70:207-13. [PMID:
9696208 DOI:
10.1016/s0015-0282(98)00177-0]
[Citation(s) in RCA: 173] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE
To analyze the efficacy and cost-effectiveness of alternative treatments for unexplained infertility.
DESIGN
Retrospective analysis of 45 published reports.
SETTING
Clinical practices.
PATIENT(S)
Couples who met criteria for unexplained infertility. Women with Stage I or Stage II endometriosis were included.
INTERVENTION(S)
Observation; clomiphene citrate (CC); gonadotropins (hMG); IUI; and GIFT and IVF.
MAIN OUTCOME MEASURE(S)
Clinical pregnancy rate.
RESULT(S)
Combined pregnancy rates per initiated cycle, adjusted for study quality, were as follows: no treatment = 1.3%-4.1%; IUI = 3.8%; CC = 5.6%; CC + IUI = 8.3%; hMG = 7.7%; hMG + IUI = 17.1%; IVF = 20.7%; GIFT = 27.0%. The estimated cost per pregnancy was $10,000 for CC + IUI, $17,000 for hMG + IUI, and $50,000 for IVF.
CONCLUSION(S)
Clomiphene citrate + IUI is a cost-effective treatment for unexplained infertility. If this treatment fails, hMG + IUI and assisted reproduction are efficacious therapeutic options.
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