Patients' preferences in deciding between intrauterine insemination and expectant management

Pieternel Steures*, Jidske C. Berkhout, Peter G.A. Hompes, Jan Willem van der Steeg, Patrick M.M. Bossuyt, Fulco van der Veen, J. Dik F. Habbema, Marinus J.C. Eijkemans, Ben W.J. Mol

*Corresponding author for this work

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Abstract

Background: Intrauterine insemination (IUI) is a commonly used treatment in subfertile couples. We assessed patients' preferences for IUI relative to expectant management. Methods: Forty subfertile couples were offered scenarios in which the treatment-independent pregnancy chance was varied against a fixed pregnancy chance after IUI without or with controlled ovarian hyperstimulation (COH) of 8% and 12% per cycle, respectively. The treatment-independent pregnancy chance within 12 months was initially set at 100%, and subsequently reduced until couples switched preferences. We also investigated the impact of the risks of ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy on couples' preferences. Results: When pregnancy was guaranteed within a year, all couples would opt for expectant management. Most couples switched to IUI without COH at a 60% chance of a treatment-independent pregnancy and to IUI with COH between a 40% and 60% chance. Where the risk of OHSS was set at 10%, a large majority of the couples preferred expectant management to IUI. At a multiple pregnancy risk of 100%, 77% of the couples would still prefer IUI. Conclusions: The majority of couples prefer IUI with or without COH when the treatment-independent pregnancy chance in the next 12 months is <50% and <40%, respectively. The risk of a multiple pregnancy does not affect their preference for IUI, whereas IUI is rejected when the risk of OHSS exceeds 10%.

Original languageEnglish
Pages (from-to)752-755
Number of pages4
JournalHuman Reproduction
Volume20
Issue number3
DOIs
Publication statusPublished - Mar 2005

Keywords

  • Intrauterine insemination
  • Preference
  • Subfertility

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    Steures, P., Berkhout, J. C., Hompes, P. G. A., van der Steeg, J. W., Bossuyt, P. M. M., van der Veen, F., Habbema, J. D. F., Eijkemans, M. J. C., & Mol, B. W. J. (2005). Patients' preferences in deciding between intrauterine insemination and expectant management. Human Reproduction, 20(3), 752-755. https://doi.org/10.1093/humrep/deh673