Cited by 453Reproductive Health and TechnologiesAssisted Reproductive Technology and Twin PregnancyReproductive Biology and Fertility

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Intrauterine insemination or in-vitro fertilisation in idiopathic subfertility and male subfertility: a randomised trial and cost-effectiveness analysis

Goverde, Angelique J, McDonnell, Joseph, Vermeiden, Jan PW, Schats, Roel, Rutten, Frans FH, Schoemaker, Joop·2000·The Lancet

DOI 10.1016/s0140-6736(99)04002-7

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Abstract

Background Couples affected by idiopathic subfertility or male subfertility have an estimated spontaneous conception rate of about 2% per cycle. Although various infertility treatments are available, counselling of a couple in their choice of treatment is difficult because of the lack of consistent data from good-quality comparative studies. We compared the results of treatment with intrauterine insemination (IUI) with those of in-vitro fertilisation (IVF), and did a cost-effectiveness analysis. Methods In a prospective, randomised, parallel trial, 258 couples with idiopathic subfertility or male subfertility were treated for a maximum of six cycles of either IUI in the spontaneous cycle (IUI alone), IUI after mild ovarian hyperstimulation, or IVF. The primary endpoint was a pregnancy resulting in at least one livebirth after treatment. Cost-effectiveness based on real costs was studied by Markov chain analysis. Findings 86 couples were assigned IUI alone, 85 IUI plus ovarian hyperstimulation, and 87 IVF. Ten couples dropped out before treatment began. Although the pregnancy rate per cycle was higher in the IVF group than in the IUI groups (12.2% vs 7.4% and 8.7%, respectively; p=0.09), the cumulative pregnancy rate for IVF was not significantly better than that for IUI. Couples in the IVF group were more likely than those in the IUI groups to give up treatment before their maximum of six attempts (37 [42%] drop-outs vs 13 [15%] and 14 [16%], respectively; p Interpretation Co…

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Authors: Goverde, A. J., McDonnell, J., Vermeiden, J. P., Schats, R., Rutten, F. F., & Schoemaker, J.
Affiliations: Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
Erasmus University Rotterdam (NL)
Corresponding author: Goverde, Angelique J
ORCID: Goverde, Angelique J
Venue: The Lancet
Publisher: Elsevier BV
Published: 2000-01
Volume: 355
Issue: 9197
Pages: 13-18
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(99)04002-7
OpenAlex: W2110055479
Cited by: 453
References: 26
Citations by year: 2026: 3 · 2025: 5 · 2024: 3 · 2023: 6 · 2022: 11 · 2021: 19 · 2020: 13 · 2019: 14 · 2018: 12 · 2017: 18 · 2016: 19 · 2015: 14 · 2014: 12 · 2013: 24 · 2012: 16
FWCI: 20.78
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
Keywords: in vitro fertilization, male subfertility, cost-effectiveness, ovarian hyperstimulation, treatment discontinuation, Markov chain analysis
MeSH terms: Adult, Cost-Benefit Analysis, Female, Fertilization in Vitro, Humans, Infertility, Insemination, Artificial, Male, Markov Chains, Pregnancy, Sperm Count, Treatment Outcome

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Intrauterine insemination or in-vitro fertilisation in idiopathic subfertility and male subfertility: a randomised trial and cost-effectiveness analysis

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