Couples with unexplained subfertility and unfavorable prognosis: a randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation

Inge M. Custers; Tamar E. König; Frank J. Broekmans; Peter G. A. Hompes; Eugenie Kaaijk; Jur Oosterhuis; Monique H. Mochtar; Sjoerd Repping; Madelon van Wely; Pieternel Steures; Fulco van der Veen; Ben W. J. Mol

doi:https://doi.org/10.1016/j.fertnstert.2011.08.005

Couples with unexplained subfertility and unfavorable prognosis: a randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation

Inge M. Custers, Tamar E. König, Frank J. Broekmans, Peter G. A. Hompes, Eugenie Kaaijk, Jur Oosterhuis, Monique H. Mochtar, Sjoerd Repping, Madelon van Wely, Pieternel Steures, Fulco van der Veen, Ben W. J. Mol

Research output: Contribution to journal › Article › Academic › peer-review

42 Citations (Scopus)

Abstract

To evaluate the effectiveness of IVF with elective single embryo transfer (IVF-eSET) vs. IUI with controlled ovarian stimulation (IUI-COS) as an alternative treatment to reduce the risk for a multiple pregnancy. Randomized pilot trial. Three academic and six teaching hospitals in the Netherlands. Couples with unexplained or mild male subfertility and an unfavorable prognosis for natural conception. One cycle of IVF-eSET or three cycles of IUI-COS. Ongoing pregnancy per couple. We randomly allocated 116 women to IVF-eSET (n = 58) or IUI-COH (n = 58). There were 14 ongoing pregnancies (24%) in the IVF-eSET group and 12 pregnancies (21%) in the IUI-COS group (relative ratio 1.17; 95% confidence interval 0.60-2.30). There were two twin pregnancies in the IVF-eSET group (14%) and two twin pregnancies and one triplet pregnancy in the IUI-COH group (25%). In patients with unexplained or mild male subfertility and a poor prognosis for natural conception, one cycle of IVF-eSET might be as effective as three cycles of IUI-COS as primary treatment. Elective single embryo transfer does not seem an effective strategy in preventing multiple pregnancies in this particular population. In the future a strict SET policy (i.e., compulsory SET) might be an option. Our trial provides evidence for the feasibility and highlights the importance of a large definitive trial to determine the effectiveness and side effects of both strategies

Original language	English
Pages (from-to)	1107-11.e1
Journal	Fertility and Sterility
Volume	96
Issue number	5
DOIs	https://doi.org/10.1016/j.fertnstert.2011.08.005
Publication status	Published - 2011

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https://doi.org/10.1016/j.fertnstert.2011.08.005

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Custers, I. M., König, T. E., Broekmans, F. J., Hompes, P. G. A., Kaaijk, E., Oosterhuis, J., Mochtar, M. H., Repping, S., van Wely, M., Steures, P., van der Veen, F., & Mol, B. W. J. (2011). Couples with unexplained subfertility and unfavorable prognosis: a randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation. Fertility and Sterility, 96(5), 1107-11.e1. https://doi.org/10.1016/j.fertnstert.2011.08.005

Custers, Inge M. ; König, Tamar E. ; Broekmans, Frank J. et al. / Couples with unexplained subfertility and unfavorable prognosis: a randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation. In: Fertility and Sterility. 2011 ; Vol. 96, No. 5. pp. 1107-11.e1.

@article{182aa3c1703a493a84362326955bc475,

title = "Couples with unexplained subfertility and unfavorable prognosis: a randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation",

abstract = "To evaluate the effectiveness of IVF with elective single embryo transfer (IVF-eSET) vs. IUI with controlled ovarian stimulation (IUI-COS) as an alternative treatment to reduce the risk for a multiple pregnancy. Randomized pilot trial. Three academic and six teaching hospitals in the Netherlands. Couples with unexplained or mild male subfertility and an unfavorable prognosis for natural conception. One cycle of IVF-eSET or three cycles of IUI-COS. Ongoing pregnancy per couple. We randomly allocated 116 women to IVF-eSET (n = 58) or IUI-COH (n = 58). There were 14 ongoing pregnancies (24%) in the IVF-eSET group and 12 pregnancies (21%) in the IUI-COS group (relative ratio 1.17; 95% confidence interval 0.60-2.30). There were two twin pregnancies in the IVF-eSET group (14%) and two twin pregnancies and one triplet pregnancy in the IUI-COH group (25%). In patients with unexplained or mild male subfertility and a poor prognosis for natural conception, one cycle of IVF-eSET might be as effective as three cycles of IUI-COS as primary treatment. Elective single embryo transfer does not seem an effective strategy in preventing multiple pregnancies in this particular population. In the future a strict SET policy (i.e., compulsory SET) might be an option. Our trial provides evidence for the feasibility and highlights the importance of a large definitive trial to determine the effectiveness and side effects of both strategies",

author = "Custers, {Inge M.} and K{\"o}nig, {Tamar E.} and Broekmans, {Frank J.} and Hompes, {Peter G. A.} and Eugenie Kaaijk and Jur Oosterhuis and Mochtar, {Monique H.} and Sjoerd Repping and {van Wely}, Madelon and Pieternel Steures and {van der Veen}, Fulco and Mol, {Ben W. J.}",

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language = "English",

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Custers, IM, König, TE, Broekmans, FJ, Hompes, PGA, Kaaijk, E, Oosterhuis, J, Mochtar, MH , Repping, S , van Wely, M, Steures, P, van der Veen, F & Mol, BWJ 2011, 'Couples with unexplained subfertility and unfavorable prognosis: a randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation', Fertility and Sterility, vol. 96, no. 5, pp. 1107-11.e1. https://doi.org/10.1016/j.fertnstert.2011.08.005

Couples with unexplained subfertility and unfavorable prognosis: a randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation. / Custers, Inge M.; König, Tamar E.; Broekmans, Frank J. et al.
In: Fertility and Sterility, Vol. 96, No. 5, 2011, p. 1107-11.e1.

Research output: Contribution to journal › Article › Academic › peer-review

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T1 - Couples with unexplained subfertility and unfavorable prognosis: a randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation

AU - Custers, Inge M.

AU - König, Tamar E.

AU - Broekmans, Frank J.

AU - Hompes, Peter G. A.

AU - Kaaijk, Eugenie

AU - Oosterhuis, Jur

AU - Mochtar, Monique H.

AU - Repping, Sjoerd

AU - van Wely, Madelon

AU - Steures, Pieternel

AU - van der Veen, Fulco

AU - Mol, Ben W. J.

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N2 - To evaluate the effectiveness of IVF with elective single embryo transfer (IVF-eSET) vs. IUI with controlled ovarian stimulation (IUI-COS) as an alternative treatment to reduce the risk for a multiple pregnancy. Randomized pilot trial. Three academic and six teaching hospitals in the Netherlands. Couples with unexplained or mild male subfertility and an unfavorable prognosis for natural conception. One cycle of IVF-eSET or three cycles of IUI-COS. Ongoing pregnancy per couple. We randomly allocated 116 women to IVF-eSET (n = 58) or IUI-COH (n = 58). There were 14 ongoing pregnancies (24%) in the IVF-eSET group and 12 pregnancies (21%) in the IUI-COS group (relative ratio 1.17; 95% confidence interval 0.60-2.30). There were two twin pregnancies in the IVF-eSET group (14%) and two twin pregnancies and one triplet pregnancy in the IUI-COH group (25%). In patients with unexplained or mild male subfertility and a poor prognosis for natural conception, one cycle of IVF-eSET might be as effective as three cycles of IUI-COS as primary treatment. Elective single embryo transfer does not seem an effective strategy in preventing multiple pregnancies in this particular population. In the future a strict SET policy (i.e., compulsory SET) might be an option. Our trial provides evidence for the feasibility and highlights the importance of a large definitive trial to determine the effectiveness and side effects of both strategies

AB - To evaluate the effectiveness of IVF with elective single embryo transfer (IVF-eSET) vs. IUI with controlled ovarian stimulation (IUI-COS) as an alternative treatment to reduce the risk for a multiple pregnancy. Randomized pilot trial. Three academic and six teaching hospitals in the Netherlands. Couples with unexplained or mild male subfertility and an unfavorable prognosis for natural conception. One cycle of IVF-eSET or three cycles of IUI-COS. Ongoing pregnancy per couple. We randomly allocated 116 women to IVF-eSET (n = 58) or IUI-COH (n = 58). There were 14 ongoing pregnancies (24%) in the IVF-eSET group and 12 pregnancies (21%) in the IUI-COS group (relative ratio 1.17; 95% confidence interval 0.60-2.30). There were two twin pregnancies in the IVF-eSET group (14%) and two twin pregnancies and one triplet pregnancy in the IUI-COH group (25%). In patients with unexplained or mild male subfertility and a poor prognosis for natural conception, one cycle of IVF-eSET might be as effective as three cycles of IUI-COS as primary treatment. Elective single embryo transfer does not seem an effective strategy in preventing multiple pregnancies in this particular population. In the future a strict SET policy (i.e., compulsory SET) might be an option. Our trial provides evidence for the feasibility and highlights the importance of a large definitive trial to determine the effectiveness and side effects of both strategies

U2 - https://doi.org/10.1016/j.fertnstert.2011.08.005

DO - https://doi.org/10.1016/j.fertnstert.2011.08.005

M3 - Article

C2 - 21890134

SN - 0015-0282

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Custers IM, König TE, Broekmans FJ, Hompes PGA, Kaaijk E, Oosterhuis J et al. Couples with unexplained subfertility and unfavorable prognosis: a randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation. Fertility and Sterility. 2011;96(5):1107-11.e1. doi: https://doi.org/10.1016/j.fertnstert.2011.08.005