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Study: Infertility Treatments No Help

Drug Treatment and Intrauterine Insemination May Not Work When Used Separately
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WebMD Health News
Reviewed by Louise Chang, MD

Aug. 7, 2008 -- Two common infertility treatments do not improve fertility, according to a study conducted in the U.K.

Researchers compared drug treatment to induce ovulation with no treatment; they also compared intrauterine insemination -- in which the sperm are placed inside the uterus to facilitate fertilization -- with no treatment. They only studied couples with unexplained infertility, only one of many reasons for failing to conceive.

"What we found is that neither of these popular and commonly used treatments offered a higher birth rate than no treatment at all," says Siladitya Bhattacharya, MD, a professor of reproductive medicine at the University of Aberdeen in Scotland and the study's lead author. "What we've shown is that neither of these first-line treatments is better than [the couples] trying themselves."

The rate of live births was 17% for the no-treatment group, 14% for the medication group, and 23% for the insemination group. "There were no significant differences between them," Bhattacharya tells WebMD.

But U.S. fertility experts who reviewed the study for WebMD say the findings probably have little relevance for infertile couples with unexplained infertility in the U.S. because the two infertility treatments -- each compared singly to no treatment in the U.K. study -- are typically used in combination here. The dose of medication used in the U.K. study is also much lower than what is typically prescribed in the U.S.

Infertility Treatments Fall Short

Bhattacharya and his colleagues recruited 580 infertile women, average age 32, from five hospitals in Scotland, randomly assigning them to one of three groups:

  • The medication group took a 50 milligram oral dose of Clomid. If that overstimulated the ovaries, the dose was dropped to 25 milligrams. They were given advice about the best times to have intercourse.
  • In the intrauterine insemination group, women monitored their hormone levels and when they were ideal, the sperm were placed inside the uterus to facilitate fertilization.
  • The no-treatment group was given general advice about the need to have intercourse regularly during the six-month study.

All the women had been trying unsuccessfully to become pregnant naturally for at least two years. All had unexplained infertility, a condition in which doctors are unable to find any abnormalities after doing tests such as semen analysis, evaluating the fallopian tubes, or ovulation. About one in seven couples are infertile, with about one-quarter of those experiencing unexplained infertility, according to the researchers.

Comparing Infertility Treatments

At the study's end, 32 women (17%) in the no-treatment group had given birth, compared to 26 (14%) in the medication group and 43 (23%) in the insemination group.

More women who got either the insemination or the medication found the process more acceptable than those who got no treatment, the researchers found.

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