IVF for unexplained subfertility; whom should we treat?

Which couples with unexplained subfertility can expect increased chances of ongoing pregnancy with IVF compared to expectant management? For couples in which the woman is under 40 years of age, IVF is associated with higher chances of conception than expectant management. The clinical indications fo...

Full description

Saved in:
Bibliographic Details
Published in:Human reproduction (Oxford) 2019-07, Vol.34 (7), p.1249-1259
Main Authors: van Eekelen, R, van Geloven, N, van Wely, M, Bhattacharya, S, van der Veen, F, Eijkemans, M J, McLernon, D J
Format: Article
Language:English
Subjects:
Adult
Female
Fertilization in Vitro - statistics & numerical data
Humans
Infertility
Infertility - therapy
Maternal Age
Original
Pregnancy
Pregnancy Rate
Retrospective Studies
Watchful Waiting - statistics & numerical data
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Which couples with unexplained subfertility can expect increased chances of ongoing pregnancy with IVF compared to expectant management? For couples in which the woman is under 40 years of age, IVF is associated with higher chances of conception than expectant management. The clinical indications for IVF have expanded over time from bilateral tubal blockage to include unexplained subfertility in which there is no identifiable barrier to conception. Yet, there is little evidence from randomized controlled trials that IVF is effective in these couples. We compared outcomes in British couples with unexplained subfertility undergoing IVF (n = 40 921) from registry data to couples with the same type of subfertility on expectant management. Those couples on expectant management (defined as no intervention aside from the advice to have intercourse) comprised a prospective nation-wide Dutch cohort (n = 4875) and a retrospective regional cohort from Aberdeen, Scotland (n = 975). We excluded couples who had tried for
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/dez072