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Fertil Steril. 1998 Aug;70(2):207-13.
Efficacy of treatment for unexplained infertility. Guzick DS
,Sullivan MW,Adamson GD,Cedars MI,Falk RJ,
Peterson EP,Steinkampf MP
.
University of Rochester, New York, USA.
Objectives:
To analyze the efficacy and cost-effectiveness of alternative treatments for unexplained infertility.
Design:
Retrospective analysis of 45 published reports.
Setting:
Clinical practices.
Patients:
Couples who met criteria for unexplained infertility. Women with Stage I or Stage II endometriosis were included.
Intervention(s):
Observation; clomiphene citrate (CC); gonadotropins (hMG); IUI; and GIFT and IVF.
Settings, Design and Main Outcome Measures:
Clinical pregnancy rate.
Result(s):
Combined pregnancy rates per initiated cycle, adjusted for study quality, were as follows: no treatment = 1.3%-4.1%; IUI = 3.8%; CC = 5.6%; CC + IUI = 8.3%; hMG = 7.7%; hMG + IUI = 17.1%; IVF = 20.7%; GIFT = 27.0%. The estimated cost per pregnancy was $10,000 for CC + IUI, $17,000 for hMG + IUI, and $50,000 for IVF.
Conclusion(s):
Clomiphene citrate + IUI is a cost-effective treatment for unexplained infertility. If this treatment fails, hMG + IUI and assisted reproduction are efficacious therapeutic options.
   
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