Replacing IUI with IVF for initial treatment of unexplained infertility: why this NICE recommendation is cause for concern
| Autor: | Mathew Tomlinson, Jackson Kirkman-Brown, Bryan Woodward |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Infertility
Adult medicine.medical_specialty media_common.quotation_subject Cost-Benefit Analysis Nice Fertilization in Vitro 03 medical and health sciences 0302 clinical medicine Excellence Pregnancy Risk Factors medicine Initial treatment Humans 030212 general & internal medicine Intensive care medicine health care economics and organizations media_common computer.programming_language Unexplained infertility Insemination Artificial Homologous Gynecology Ivf treatment 030219 obstetrics & reproductive medicine business.industry Treatment process Obstetrics and Gynecology General Medicine medicine.disease United Kingdom Clinical trial Reproductive Medicine Practice Guidelines as Topic Female business computer |
| Zdroj: | Human fertility (Cambridge, England). 19(2) |
| ISSN: | 1742-8149 |
| Popis: | The latest guidelines from the National Institute for Health and Care Excellence (NICE) for assisted conception recommend that people experiencing unexplained infertility should no longer be offered stimulated intra-uterine insemination (IUI) as a first-line treatment, but rather be directed towards IVF or alternatively be left to expectant management. NICE has acknowledged that the cited evidence leading to this decision was not sufficiently robust. As such, we are concerned that accordance with these new NICE guidelines may result in people with no identifiable cause of their infertility being prematurely referred for IVF treatment. Since IVF constitutes a more invasive and expensive treatment process, which also represents an additional and unnecessary cost pressure to the National Health Service, there is a longstanding need for a robust clinical trial to resolve the uncertainty as to whether one treatment is more appropriate than another. Until such data is available, we suggest that provision of stimulated IUI, in centres achieving a satisfactory live birth rate, represents a significant cost-saving to those commissioning fertility services, with lower risks to people treated. |
| Databáze: | OpenAIRE |
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