UK success rates for intrauterine insemination (IUI) are much closer to in vitro fertilisation (IVF) rates than previously thought, reports a new study in BMJ Open.
The study used data from the UK Human Fertilisation and Embryology Authority database for 319,105 cycles of IVF/intracytoplasmic sperm injection and 30,669 IUI cycles carried out from 2012 to 2016.
Live birth rate per cycle (LBR) for IVF improved between 2012 (25.47%) and 2016 (27.32%). The absolute difference was 1.84 per cent (relative risk [RR], 1.07; 95% CI, 1.05-1.09; P<.001 there was no change in iui success over the same period vs absolute difference per cent ci>
IVF had a significantly higher LBR compared with IUI (26.96% vs 11.49%). The absolute difference was 15.47 per cent (RR, 2.35 [95% CI, 2.27-2.42] P<.001 suggesting an additional birth will be achieved for every ivf cycles compared with iui needed to treat>
The rate of multiple gestation pregnancy as a proportion of all births was significantly higher after IVF than IUI (13.88% vs 9.59%; absolute difference, 4.29%; RR, 1.45 [95% CI, 1.31-1.60]; P<.001 an additional multiple pregnancy will occur for every ivf pregnancies compared with iui>
IVF was associated with 781 cases of ovarian hyperstimulation syndrome in 2016, whereas IUI was associated with none. Similarly, the number of foetal reductions was higher with IVF compared with IUI (159 vs 0), and this was also seen with the number of terminations (697 vs 0).
Based on 2016 costs, IVF maternal and neonatal cost was about £115 million compared with £3 million for IUI.
The authors concluded that it is prudent to offer IUI before IVF throughout the UK.