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8 August 2008
Experts pooh-pooh common fertility treatments

Long established fertility interventions, such as the drug clomifene citrate and treatments such as unstimulated intrauterine insemination, do not seem to improve fertility, says a new study in the British Medical Journal. The new findings are controversial and present a significant challenge to current fertility-boosting practices.

The new study compared the effectiveness of two specific interventions. The researchers, from the University of Aberdeen in Scotland, recruited 580 women who had experienced unexplained infertility for more than two years. The women were randomized into three groups—one group of women were encouraged to try naturally for a pregnancy and had no medical interventions; one took oral clomifene citrate (CC) which is believed to correct subtle ovulatory dysfunction; and the other had unstimulated intra-uterine insemination (IUI) of sperm.

Overall, 101 women became pregnant and had a live birth during the course of the study. The researchers found that women who had no interventions had a live birth rate of 17 percent, the group taking oral CC had a birth rate of 14 percent, and the group having unstimulated IUI had a birth rate of 23 percent. The researchers point out that to have a meaningful and significant improvement in the live birth rate, the difference in live births between unstimulated IUI and no intervention would have to be much higher than the 6 percent reported in this trial.

Interestingly, women on active treatments (CC and IUI) were reassured by the process of treatment while women who had no interventions were less satisfied, despite it being equally effective. "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 researchers concluded.

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Source: British Medical Journal

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