Double versus single homologous intrauterine insemination for male factor infertility： a systematic review and meta-analysis

作     者：Apostolos Zavos Alexandros Daoonte Antonios Garas Christina Verykouki Evangelos Papanikolao~ Georgios Anifandis Nikolaos P Polyzos 

作者机构：Obstetrics and Gynecology University Hospital of Larissa Larissa 41110 Greece Aristotle University of Thessaloniki Assisted Reproduction Unit 1st OB-GYN Department Thessaloniki 56429 Greece and University Hospital Dutch-Speaking Free University of Brussels Brussels City 1090 Belgium 

出 版 物：《Asian Journal of Andrology》 (亚洲男性学杂志（英文版）)

年 卷 期：2013年第15卷第4期

页      面：533-538,I0010页

核心收录：

学科分类：090603[农学-临床兽医学] 080901[工学-物理电子学] 0809[工学-电子科学与技术（可授工学、理学学位）] 08[工学] 080401[工学-精密仪器及机械] 09[农学] 0906[农学-兽医学] 0804[工学-仪器科学与技术] 0803[工学-光学工程] 

主　　题：homologous intrauterine insemination male infertility meta-analysis systematic review 

摘      要：Male factor infertility affects 30%-50% of infertile couples worldwide, and there is an increasing interest in the optimal management of these patients. In studies comparing double and single intrauterine insemination （IUI）, a trend towards higher pregnancy rates in couples with male factor infertility was observed. Therefore, we set out to perform a meta-analysis to examine the superiority of double versus single IUI with the male partner＇s sperm in couples with male factor infertility. An odds ratio （OR） of 95% confidence intervals （CIs） was calculated for the pregnancy rate. Outcomes were analysed by using the ManteI-Haesel or DerSimonian-Laird model accordingto the heterogeneity of the results. Overall, five trials involving 1125 IUI cycles were included in the meta-analysis. There was a two-fold increase in pregnancies after a cycle with a double IUI compared with a cycle with a single IUI （OR. 2.0; 95% CI. 1.07-3.75; P〈O.03）. Nevertheless, this result was mainly attributed to the presence of a large trial that weighted as almost 50% in the overall analysis. Sensitivity analysis, excluding this large trial, revealed only a trend towards higher pregnancy rates among double IUI cycles （OR. 1.58; 95% CI. 0.59-4.21）, but without statistical significance （P=0.20）. Our systematic review highlights that the available evidence regarding the use of double IUI in couples with male factor infertility is fragmentary and weak. Although there may be a trend towards higher pregnancy rates when the number of IUIs per cycle is increased, further large and well-designed randomized trials are needed to provide solid evidence toide current clinical practice.