Total fertilization failure and idiopathic subfertility
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BioMed Central
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Total fertilization failure and idiopathic subfertility Sandra J Tanahatoe1,2, Joseph McDonnell1, Angelique J Goverde3, Peter GA Hompes1 and Cornelis B Lambalk*1 Address: 1Department of Obstetrics, Gynaecology and Reproductive Medicine, Vrije Universiteit medical centre, Amsterdam, The Netherlands, 2Department of Obstetrics, Gynaecology and Reproductive Medicine, Vrije Universiteit medical centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands and 3Department of reproductive Medicine and Gynaecology, University Medical Centre Utrecht, The Netherlands Email: Sandra J Tanahatoe - [email protected]; Joseph McDonnell - [email protected]; Angelique J Goverde - [email protected]; Peter GA Hompes - [email protected]; Cornelis B Lambalk* - [email protected] * Corresponding author
Published: 12 January 2009 Reproductive Biology and Endocrinology 2009, 7:3
doi:10.1186/1477-7827-7-3
Received: 23 September 2008 Accepted: 12 January 2009
This article is available from: http://www.rbej.com/content/7/1/3 © 2009 Tanahatoe et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: To gain more insight in whether failure of intrauterine insemination (IUI) treatment in patients with idiopathic subfertility could be related to diminished fertilization, the aim of this study is to compare the fertilization of an initial IVF procedure after six cycles of IUI and the fertilization of an initial IVF procedure without preceding IUI cycles in couples with idiopathic subfertility. Methods: We performed a complimentary analysis of a randomized controlled trial, in which the number of total fertilization failure (TFF) in the first IVF procedure after unsuccessful IUI was compared to those of IVF without preceding IUI in patients with idiopathic subfertility. These patients participated in a previous study that assessed the cost effectiveness of IUI versus IVF in idiopathic subfertility and were randomized to either IUI or IVF treatment. Results: 45 patients underwent IVF after 6 cycles of unsuccessful IUI and 58 patients underwent IVF immediately without preceding IUI. In 7 patients the IVF treatment was cancelled before ovum pick. In the IVF after unsuccessful IUI group TFF was seen in 2 of the 39 patients (5%) versus 7 of the 56 patients (13%) in the immediate IVF group. After correction for confounding factors the TFF rate was not significantly different between the two groups (p = 0.08, OR 7.4; 95% CI: 0.5–14.9). Conclusion: Our data showed that TFF and the fertilization rate in the first IVF treatment were not significantly different between couples with idiopathic subfertility undergoing IVF after failure of IUI versus those couples undergoing IVF immediately without prior IUI treatment. Apparently, impaired fertilization
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