Expert Working Groups (EWG)

GFMER Global Consultation on WHO Infertility Guidelines
EWG: IUI with or without ovarian stimulation

Chair: Willem Ombelet (Belgium)

Members

• Ben Cohlen (Netherlands)
• Geeta Nargund (UK)
• Carin Huyser (South Africa)
• Aucky Hinting (Indonesia)

Participants

• Abubakar Abubakar Panti - Department of Obstetrics and Gynecology, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
• Ado Geidam - Department of Obstetrics and Gynecology, University of Maiduguri, Nigeria
• Audu Idrisa - Department of Obstetrics and Gynecology, University of Maiduguri, Nigeria
• Desalegn Tegabu Zegeye - College of Medicine and Health Sciences, University of Gondar, Ethiopia
• Ehab ElBayoumi - Port Said General Hospital, Ministry of Health and Population, Egypt
• Jacoline Albert - Quaid-e-Azam International Hospital, Islamabad, Pakistan
• Maia Chiokadze - Center of Reproductive Medicine “Embriotox”, Tbilisi, Georgia
• Matilda Bannerman Wulff - MightyCrag Maternity Home, Accra, Ghana
• Mengistu Welday Gebremichael - Mekelle University, Ethiopia
• Zewdu Dememew - Johns Hopkins University-Technical Support for the Ethiopian HIV AIDS Initiative, Hawassa, Ethiopia

WHO DRAFT PICO Questions:

Population Intervention Comparator Outcome (PICO):
Being developed to find the evidence in order to determine if a Recommendation on best practice can be made by the World Health Organization concerning the following topic.

INTRAUTERINE INSEMINATION (WITH OR WITHOUT OVARIAN STIMULATION)

(P = women and men of reproductive age – questions may include exclusion or inclusion criteria)

Should WHO develop a recommendation concerning:

1. the indications which would suggest use of IUI versus maintenance of timed intercourse of expected management?
2. the indications for ovarian stimulation versus natural cycle when providing an IUI intervention?
3. the optimal methods (primary and secondary measures) to be used to prevent of multiple gestations during an IUI intervention?
4. the optimal methods (primary and secondary measures) to be used to prevent of multiple gestations during an IUI intervention?
5. when to initiate the process for an IUI intervention without ovarian stimulation in couples attempting pregnancy?
6. when to initiate the process for an IUI intervention with ovarian stimulation in couples attempting pregnancy?
7. the optimal method of timing for IUI in natural cycles?
8. the optimal timing for stimulation methods in IUI with stimulated cycles?
9. the optimal timing for insemination following hCG administration for the LH surge? (early IUI versus late IUI)
10. the optimal number of IUIs per cycle?
11. whether there is value in providing bed rest following an IUI procedure?
12. the number of consecutive IUI treatment cycles would be in which pregnancy rates continue to significantly increase?
13. the number of consecutive IUI treatment cycles would be considered optimal prior to referral to IVF/ICSI.
14. the value of “fallopian sperm perfusion” (FSP) in comparison to IUI?
15. the influence of sperm quality (number, motility, morphology) on IUI outcomes?
16. which semen preparation technique yields the most effective results (in terms of pregnancy rates)?
17. the cost-effectiveness of IUI in comparison to IVF/ICSI?
18. whether there are differences in perinatal outcomes between natural cycle IUI and IUI with ovarian stimulation?
19. whether there are differences in perinatal outcomes between IUI and IVF/ICSI?
20. The laboratory diagnostic tests that should be performed and are most effective (sensitivity, specificity) in diagnosing patient infections prior to offering IUI treatment?
21. which sperm preparation is most effective in reducing infectious agents in sperm for use in an IUI procedure?
22. the laboratory procedures (equipment) that are essential for prevention of procedural or environmental contamination in an IUI programme?