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Hum Reprod. 2005 Mar;20(3):752-5. Epub 2005 Jan 7.

Patients' preferences in deciding between intrauterine insemination and expectant management.

Author information

1
Department of Obstetrics & Gynaecology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands. pn.steures@amc.uva.nl

Abstract

BACKGROUND:

Intrauterine insemination (IUI) is a commonly used treatment in subfertile couples. We assessed patients' preferences for IUI relative to expectant management.

METHODS:

Forty subfertile couples were offered scenarios in which the treatment-independent pregnancy chance was varied against a fixed pregnancy chance after IUI without or with controlled ovarian hyperstimulation (COH) of 8% and 12% per cycle, respectively. The treatment-independent pregnancy chance within 12 months was initially set at 100%, and subsequently reduced until couples switched preferences. We also investigated the impact of the risks of ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy on couples' preferences.

RESULTS:

When pregnancy was guaranteed within a year, all couples would opt for expectant management. Most couples switched to IUI without COH at a 60% chance of a treatment-independent pregnancy and to IUI with COH between a 40% and 60% chance. Where the risk of OHSS was set at 10%, a large majority of the couples preferred expectant management to IUI. At a multiple pregnancy risk of 100%, 77% of the couples would still prefer IUI.

CONCLUSIONS:

The majority of couples prefer IUI with or without COH when the treatment-independent pregnancy chance in the next 12 months is <50% and <40%, respectively. The risk of a multiple pregnancy does not affect their preference for IUI, whereas IUI is rejected when the risk of OHSS exceeds 10%.

PMID:
15640260
DOI:
10.1093/humrep/deh673
[Indexed for MEDLINE]
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