Trial reportBMJ (Clinical research ed.)2008
Clomifene citrate or unstimulated intrauterine insemination compared with expectant management for unexplained infertility: pragmatic randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 7 syntheses or guidelines pooled it, 195 citations in OpenAlex.
- Evidence-based guideline: unexplained infertility†.Human reproduction (Oxford, England) · 2023Guideline
- In vitro fertilisation for unexplained subfertility.The Cochrane database of systematic reviews · 2023Pooled it
- Intra-uterine insemination for unexplained subfertility.The Cochrane database of systematic reviews · 2020Pooled it
- Interventions for unexplained infertility: a systematic review and network meta-analysis.The Cochrane database of systematic reviews · 2019Pooled it
- In vitro fertilisation for unexplained subfertility.The Cochrane database of systematic reviews · 2015Pooled it
- Female infertility.BMJ clinical evidence · 2010Pooled it
- Clomiphene citrate for unexplained subfertility in women.The Cochrane database of systematic reviews · 2010Pooled it
- The web-based Pleasure&Pregnancy programme in the treatment of unexplained infertility: a randomized controlled trial.Human reproduction (Oxford, England) · 2024Trial
- Male infertility.Systems biology in reproductive medicine · 2025Review
- Effect of music on anxiety during intrauterine insemination: a randomized controlled trial.F&S reports · 2025Article
- Improved reproductive outcomes in normogonadotropic oligomenorrheic women undergoing ovarian stimulation with intrauterine insemination: a retrospective cohort analysis of real-world data.Frontiers in endocrinology · 2024Article
- Using Quantitative Hormonal Fertility Monitors to Evaluate the Luteal Phase: Proof of Concept Case Study.Medicina (Kaunas, Lithuania) · 2023Article
- Pharmacotherapy for Infertility in Ghana: A Prospective Study on Prescription Patterns and Treatment Outcomes among Women undergoing Fertility Treatment.Current therapeutic research, clinical and experimental · 2023Article
- The effect of sperm DNA fragmentation on in vitro fertilization outcomes of unexplained infertility.Clinics (Sao Paulo, Brazil) · 2023Article
- 'Just have some IVF!': A longitudinal ethnographic study of couples' experiences of seeking fertility treatment.Sociology of health & illness · 2022Article
- Efficacy of intrauterine insemination in women with endometrioma-associated subfertility: analysis using propensity score matching.BMC pregnancy and childbirth · 2022Article
- Poor Endometrial Proliferation After Clomiphene is Associated With Altered Estrogen Action.The Journal of clinical endocrinology and metabolism · 2021Article
- Review
- Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success.Journal of assisted reproduction and genetics · 2020Article
- Does different subfertility etiology affect pregnancy rates in intrauterineinsemination cycles?Turkish journal of medical sciences · 2019Article
Corrections and comments
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Authors and funding
17 authors at 6 institutions in 1 country.
Funding
Abstract
objectiveTo compare the effectiveness of clomifene citrate and unstimulated intrauterine insemination with expectant management for the treatment of unexplained infertility.
designThree arm parallel group, pragmatic randomised controlled trial.
settingFour teaching hospitals and a district general hospital in Scotland.
participantsCouples with infertility for over two years, confirmed ovulation, patent fallopian tubes, and motile sperm.
interventionExpectant management, oral clomifene citrate, and unstimulated intrauterine insemination.
main outcome measuresThe primary outcome was live birth. Secondary outcome measures included clinical pregnancy, multiple pregnancy, miscarriage, and acceptability.
results580 women were randomised to expectant management (n=193), oral clomifene citrate (n=194), or unstimulated intrauterine insemination (n=193) for six months. The three randomised groups were comparable in terms of age, body mass index, duration of infertility, sperm concentration, and motility. Live birth rates were 32/193 (17%), 26/192 (14%), and 43/191 (23%), respectively. Compared with expectant management, the odds ratio for a live birth was 0.79 (95% confidence interval 0.45 to 1.38) after clomifene citrate and 1.46 (0.88 to 2.43) after unstimulated intrauterine insemination. More women randomised to clomifene citrate (159/170, 94%) and unstimulated intrauterine insemination (155/162, 96%) found the process of treatment acceptable than those randomised to expectant management (123/153, 80%) (P=0.001 and P<0.001, respectively).
conclusionIn couples with unexplained infertility existing treatments such as empirical clomifene and unstimulated intrauterine insemination are unlikely to offer superior live birth rates compared with expectant management.
trial registrationISRCT No: 71762042.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.