Efficacy of treatment for unexplained infertility.

نویسندگان

  • D S Guzick
  • M W Sullivan
  • G D Adamson
  • M I Cedars
  • R J Falk
  • E P Peterson
  • M P Steinkampf
چکیده

OBJECTIVE To analyze the efficacy and cost-effectiveness of alternative treatments for unexplained infertility. DESIGN Retrospective analysis of 45 published reports. SETTING Clinical practices. PATIENT(S) Couples who met criteria for unexplained infertility. Women with Stage I or Stage II endometriosis were included. INTERVENTION(S) Observation; clomiphene citrate (CC); gonadotropins (hMG); IUI; and GIFT and IVF. MAIN OUTCOME MEASURE(S) Clinical pregnancy rate. RESULT(S) Combined pregnancy rates per initiated cycle, adjusted for study quality, were as follows: no treatment = 1.3%-4.1%; IUI = 3.8%; CC = 5.6%; CC + IUI = 8.3%; hMG = 7.7%; hMG + IUI = 17.1%; IVF = 20.7%; GIFT = 27.0%. The estimated cost per pregnancy was $10,000 for CC + IUI, $17,000 for hMG + IUI, and $50,000 for IVF. CONCLUSION(S) Clomiphene citrate + IUI is a cost-effective treatment for unexplained infertility. If this treatment fails, hMG + IUI and assisted reproduction are efficacious therapeutic options.

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عنوان ژورنال:
  • Fertility and sterility

دوره 70 2  شماره 

صفحات  -

تاریخ انتشار 1998