IUI compared to TI or expectant management both in natural cycle for unexplained subfertility

Patient or population: people with unexplained subfertility
Settings:
Intervention: IUI
Comparison: TI or expectant management both in natural cycle

Live birth rate per couple (all cycles)

OR 1.60
(0.92 to 2.78)

334
(1 study)

⊕⊕⊕⊝
moderate^1,2

Multiple pregnancy rate per couple

OR 0.50
(0.04 to 5.53)

334
(1 study)

⊕⊕⊕⊝
moderate^1,2

Pregnancy rate per couple (all cycles)

OR 1.53
(0.88 to 2.64)

334
(1 study)

⊕⊕⊕⊝
moderate^1,2

Ovarian Hyperstimulation Syndrome rate per woman ‐ not reported

Not estimable

‐

Miscarriage rate per couple

OR 0.77
(0.28 to 2.11)

334
(1 study)

⊕⊕⊕⊝
moderate^1,2

Ectopic pregnancy rate per couple

OR 5.06
(0.24 to 106.2)

334
(1 study)

⊕⊕⊕⊝
moderate^1,2

*The basis for the assumed risk is the median control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

IUI compared to TI or expectant management both in stimulated cycle for unexplained subfertility

Patient or population: people with unexplained subfertility
Settings:
Intervention: IUI
Comparison: TI both in stimulated cycle

Live birth rate per couple (all cycles)

OR 1.59
(0.88 to 2.88)

208
(2 studies)

⊕⊕⊕⊝
moderate^1,2

Multiple pregnancy rate per couple

OR 1.46
(0.55 to 3.87)

316
(4 studies)

⊕⊕⊝⊝
low^2,3

Pregnancy rate per couple (all cycles)

OR 1.69
(1.14 to 2.53)

517
(7 studies)

⊕⊕⊝⊝
low^1,2,3

Ovarian Hyperstimulation Syndrome rate per woman

OR 2.75
(0.11 to 69.83)

68
(1 study)

⊕⊕⊝⊝
low^2,3,4

Miscarriage rate per couple

OR 1.66
(0.56 to 4.88)

208
(2 studies)

⊕⊕⊕⊝
moderate^1,2

Ectopic pregnancy rate per couple

OR 3.06
(0.12 to 76.95)

100
(1 study)

⊕⊕⊕⊝
moderate^1,2

*The basis for the assumed risk is the median control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

IUI in natural cycle compared to IUI in stimulated cycle for unexplained subfertility

Patient or population: people with unexplained subfertility
Settings:
Intervention: IUI in natural cycle
Comparison: IUI in stimulated cycle

Live birth rate per couple (all cycles)

OR 0.48
(0.29 to 0.82)

396
(4 studies)

⊕⊕⊕⊝
moderate^1,2

Multiple pregnancy rate per couple

OR 0.33
(0.01 to 8.7)

65
(2 studies)

⊕⊕⊝⊝
low^1,2

Pregnancy rate per couple (all cycles)

OR 0.16
(0.01 to 1.77)

26
(1 study)

⊕⊕⊕⊝
moderate^1,2

Ovarian Hyperstimulation Syndrome rate per woman⁵ ‐ not measured

Not estimable³

‐

Miscarriage rate per couple

OR 0.19
(0.01 to 5.2)

26
(1 study)

⊕⊕⊝⊝
low^1,2

Ectopic pregnancy rate per couple

OR 0.15
(0.01 to 3.02)

250
(2 studies)

⊕⊕⊕⊝
moderate^1,2

*The basis for the assumed risk is the median control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

IUI in stimulated cycle compared to TI or expectant management in natural cycle for unexplained subfertility

Patient or population: people with unexplained subfertility
Settings:
Intervention: IUI in stimulated cycle
Comparison: TI or expectant management in natural cycle

Live birth rate per couple (all cycles)

OR 0.82
(0.45 to 1.49)

253
(1 study)

⊕⊕⊕⊝
moderate^1,2

Multiple pregnancy rate per couple

OR 2.00
(0.18 to 22.34)

304
(2 studies)

⊕⊕⊕⊝
moderate^1,2

Pregnancy rate per couple (all cycles)

OR 1.00
(0.59 to 1.67)

304
(2 studies)

⊕⊕⊕⊝
moderate^1,2

Ovarian Hyperstimulation rate per woman ‐ not measured

Not estimable

‐

Miscarriage rate per couple

OR 2.28
(0.84 to 6.2)

253
(1 study)

⊕⊕⊕⊝
moderate^1,2

Ectopic pregnancy rate per couple ‐ not reported

Not estimable

‐

See comment

*The basis for the assumed risk is the median control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

IUI in natural cycle compared to TI or expectant management in stimulated cycle for unexplained subfertility

Patient or population: people with unexplained subfertility
Settings:
Intervention: IUI in natural cycle
Comparison: TI in stimulated cycle

Live birth rate per couple (all cycles)

OR 1.95
(1.1 to 3.44)

342
(1 study)

⊕⊕⊕⊝
moderate¹

Multiple pregnancy rate per couple

OR 1.05
(0.07 to 16.9)

342
(1 study)

⊕⊕⊕⊝
moderate^1,2

Pregnancy rate per couple (all cycles)

OR 1.77
(1.01 to 3.08)

342
(1 study)

⊕⊕⊕⊝
moderate¹

Ovarian Hyperstimulation Syndrome rate per woman ‐ not reported

Not estimable

‐

Miscarriage rate per couple

OR 0.91
(0.32 to 2.58)

342
(1 study)

⊕⊕⊕⊝
moderate^1,2

Ectopic pregnancy rate per couple

OR 5.30
(0.25 to 111.3)

342
(1 study)

⊕⊕⊕⊝
moderate^1,2

*The basis for the assumed risk is the median control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.