Researchers compared no intervention with oral clomifene citrate (CC) and unstimulated intra-uterine insemination (IUI). The randomised trial involved 580 women who had experienced unexplained infertility for more than two years from five hospitals in Scotland.
Overall, 101 women became pregnant and had a live birth during the study. Researchers found women who had no interventions had a live birth rate of 17%, compared with 14% for CC and 23% for IUI. This difference was not statistically significant, the authors said.
‘These interventions, which have been in use for many years, are unlikely to be more effective than no treatment. These results challenge current practice, as endorsed by a national guideline in the UK,’ the authors said in the BMJ online.
‘As a direct result of the lack of evidence, many couples with unexplained infertility endure (and even request) expensive, potentially hazardous, and often unnecessary treatments,’ warned Tarek El-Toukhy and Yacoub Khalaf from the assisted conception unit at Guy’s and St Thomas’ NHS Foundation Trust, London, in an accompanying editorial.