Evidence map›Paper›PMID 34260059›Full record

SynthesisThe Cochrane database of systematic reviews2021

Double versus single intrauterine insemination (IUI) in stimulated cycles for subfertile couples.

Lidija Rakic, Elena Kostova, Ben J Cohlen, Astrid Ep Cantineau

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05885516 (Double vs Single Intrauterine Insemination in Male Factor Infertility - a Multicenter Randomized Trial), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT05885516 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Double vs Single Intrauterine Insemination in Male Factor Infertility - a Multicenter Randomized Trial

TypeinterventionalSponsorUmraniye Education and Research HospitalRan2023 to 2024Enrolled264ConditionsMale Factor InfertilityArmsintrauterine insemination
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Lidija RakicCenter for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
Elena KostovaCenter for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
Ben J CohlenDepartment of Obstetrics and Gynaecology, Isala Clinics, Zwolle, Netherlands.
Astrid Ep CantineauDepartment of Obstetrics and Gynaecology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn subfertile couples, couples who have tried to conceive for at least one year, intrauterine insemination (IUI) with ovarian hyperstimulation (OH) is one of the treatment modalities that can be offered. When IUI is performed a second IUI in the same cycle might add to the chances of conceiving. In a previous update of this review in 2010 it was shown that double IUI increases pregnancy rates when compared to single IUI. Since 2010, different clinical trials have been published with differing conclusions about whether double IUI increases pregnancy rates compared to single IUI.

objectivesTo determine the effectiveness and safety of double intrauterine insemination (IUI) compared to single IUI in stimulated cycles for subfertile couples. SEARCH

methodsWe searched the Cochrane Gynaecology and Fertility (CGF) Group trials register, CENTRAL, MEDLINE, Embase and CINAHL in July 2020 and LILACS, Google scholar and Epistemonikos in February 2021, together with reference checking and contact with study authors and experts in the field to identify additional studies. SELECTION CRITERIA: We included randomised controlled, parallel trials of double versus single IUIs in stimulated cycles in subfertile couples. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information. MAIN

resultsWe identified in nine studies involving subfertile women. The evidence was of low quality; the main limitations were unclear risk of bias, inconsistent results for some outcomes and imprecision, due to small trials with imprecise results. We are uncertain whether double IUI improves live birth rate compared to single IUI (odds ratio (OR) 1.15, 95% confidence interval (CI) 0.71 to 1.88; I AUTHORS'

conclusionsOur main analysis, of which the evidence is low quality, shows that we are uncertain if double IUI improves live birth and reduces miscarriage compared to single IUI. Our sensitivity analysis restricted to studies of low risk of selection bias for both outcomes is consistent with the main analysis. Clinical pregnancy rate may increase in the double IUI group, but this should be interpreted with caution due to the low quality evidence. We are uncertain whether double IUI has an effect on multiple pregnancy rate and ectopic pregnancy rate compared to single IUI.

Indexed as

Abortion, SpontaneousBiasConfidence IntervalsFemaleHumansInfertility, FemaleInsemination, Artificial, HomologousLive BirthMaleOdds RatioOvulation InductionPregnancyPregnancy, EctopicPregnancy, MultiplePregnancy RateRandomized Controlled Trials as Topic

Identifiers

PMID34260059
PMCPMC8406710

What OpenQuestion holds

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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.