Comparison of intrauterine insemination with timed intercourse in superovulated cycles with gonadotropins: a meta-analysis

Objective: To compare timed intercourse and IUI with the husband's sperm in patients with unexplained infertility who are undergoing superovulation with gonadotropins. Design: Meta-analysis. Ail published reports of randomized, prospective studies with an English-language abstract extracted from MEDLINE were analyzed. A crossover search was done from the papers obtained. Setting: Academic center. Patient(s): Couples with unexplained infertility. Intervention(s): Meta-analysis of studies evaluating patients superovulated with gonadotropins and randomized for timed intercourse or IUI. Main Outcome Measure(s): Pregnancy rates (PRs) were obtained. The common odds ratio (OR) and 95% confidence intervals (95% CI) were calculated. Result(s): There were 49 pregnancies in 431 cycles of timed intercourse (11.37%), whereas there were 110 pregnancies in 549 cycles of IUI (20.04%). The PRs for IUI were significantly increased compared with those for timed intercourse in superovulation cycles (common OR = 1.84; 95% CI = 1.30-2.62). Conclusion(s): On the basis of the meta-analysis of 980 cycles in randomized and prospective studies, a patient's chances of becoming pregnant are greater with IUI with her husband's sperm than with timed intercourse in cycles superovulated with gonadotropins. (C) 1998 by American Society for Reproductive Medicine.