Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb 2;25(1):162-164.
doi: 10.5935/1518-0557.20200066.

IUI needs fairer appraisal to improve patient and stakeholder choices

Gulam Bahadur  1 , Bryan Woodward  2 , Megan Carr  3 , Santanu Acharya  4 , Asif Muneer  5 , Roy Homburg  6
Affiliations

IUI needs fairer appraisal to improve patient and stakeholder choices

Gulam Bahadur et al. JBRA Assist Reprod. .

Abstract

Information supporting IVF at the expense of intrauterine insemination (IUI) has become commonplace, but it lacks critical analyses. Data from poorly practiced IUI, without an equivalent comparison to IVF, has been generalised to recommend a total abandonment of IUI in favour of IVF treatment. Our intention with this paper is to reappraise and balance arguments so that patients and stakeholders can have an unbiased informed choice. We provide information that reveals IUI to predominate over IVF in terms of integrated success, risks and cost to deliver one live birth whilst obviating the maternal and neonatal costs. Exceptional cost savings are demonstrated for IUI over IVF for fee-paying agencies and patients with lowered risks of maternal and neonatal care along with other risks including OHSS, fetal reduction and termination of pregnancies. This analysis supports the view that patients and stakeholders can choose IUI instead of IVF in most instances, except with bilateral tubal blockage and severe male factor infertility. It is apparent that fertility clinics need to re-evaluate and reconsider this field, and IUI can be of benefit to both subfertile patients and the stakeholders.

Keywords: IUI; IVF; cost efficiency; public health; stakeholder.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST

The author has no conflict of interest to declare.

References

    1. Ayeleke RO, Asseler JD, Cohlen BJ, Veltman-Verhulst SM. Intra-uterine insemination for unexplained subfertility. Cochrane Database Syst Rev. 2020;3:CD001838. doi: 10.1002/14651858.CD001838.pub6. - DOI - PMC - PubMed
    1. Bahadur G, Woodward B, Homburg R, Al-Habib A, Muneer A. Pitfalls of NICE recommendations on fertility treatment. BMJ. 2017;356:j751. doi: 10.1136/bmj.j751. - DOI - PubMed
    1. Bahadur G, Homburg R, Bosmans JE, Huirne JAF, Hinstridge P, Jayaprakasan K, Racich P, Alam R, Karapanos I, Illahibuccus A, Al-Habib A, Jauniaux E. Observational retrospective study of UK national success, risks and costs for 319,105 IVF/ICSI and 30,669 IUI treatment cycles. BMJ Open. 2020;10:e034566. doi: 10.1136/bmjopen-2019-034566. - DOI - PMC - PubMed
    1. Bensdorp AJ, Tjon-Kon-Fat RI, Bossuyt PM, Koks CA, Oosterhuis GJ, Hoek A, Hompes PG, Broekmans FJ, Verhoeve HR, de Bruin JP, van Golde R, Repping S, Cohlen BJ, Lambers MD, van Bommel PF, Slappendel E, Perquin D, Smeenk JM, Pelinck MJ, Gianotten J, et al. Prevention of multiple pregnancies in couples with unexplained or mild male subfertility: randomised controlled trial of in vitro fertilisation with single embryo transfer or in vitro fertilisation in modified natural cycle compared with intrauterine insemination with controlled ovarian hyperstimulation. BMJ. 2015;350:g7771. doi: 10.1136/bmj.g7771. - DOI - PMC - PubMed
    1. Hansen KR. Gonadotropins with intrauterine insemination for unexplained infertility-time to stop? Fertil Steril. 2020;113:333–334. doi: 10.1016/j.fertnstert.2019.10.022. - DOI - PubMed