Friday, 8 August 2008

The treatments that don't work for unexplained infertility

It seems that two commonly used fertility treatments are a waste of time when they're used to treat couples with unexplained infertility. A research project in Scotland looked at the use of Clomid (clomifene citrate) and IUI (intra-uterine insemination) and concluded that they neither of them really made much difference to the chances of conceiving.

The study followed 580 women with unexplained infertility. Some were prescribed Clomid, some were given IUI and some weren't given any treatment at all. Perhaps surprisingly, the lowest pregnancy rates were amongst the group who took Clomid. Although the IUI group did have a slightly higher pregnancy rate than those who had no treatment, the research team say the differences are small enough to be statistically meaningless, and have concluded that there may be no medical justification at all for prescribing Clomid or attempting IUI in women with unexplained infertility.

No one would want to be given a treatment that isn't going to work, and we must welcome any research that looks into the efficacy of fertility treatment. However, it does worry me that this may make it easier for local trusts to cut their spending on infertility yet further - at the moment many will pay for Clomid and IUI, but not for IVF. If they decide to stop spending on Clomid and IUI for unexplained infertility, I fear they are not going to increase their spending on IVF, and some couples may find that they can't access any kind of treatment at all. What's more, commissioners may start to assume that couples with unexplained infertility would all get pregnant eventually if they left it to Nature. I know from personal experience of more than 13 years of unexplained infertility, that this is not the case. So although it's helpful to know that these treatments may not be much use if you don't know why you aren't getting pregnant, it may not be so helpful if you end up not being able to access any other treatment instead.

You can read more about the research which is published in the BMJ at www.bmj.com

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