October 28, 2026 · The New England journal of medicine · DOI: 10.1056/NEJMoa2602728

In Vitro Fertilization or Intrauterine Insemination in Unexplained Infertility.

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This multicenter randomized trial asked whether IUI with ovarian stimulation (up to four cycles) is noninferior to one complete IVF cycle as first-line treatment for unexplained infertility. In stage 1, the cumulative live-birth rate was 31% with IUI versus 55% with IVF, so IUI was not noninferior (adjusted risk difference -24 percentage points). When stages 1 and 2 were combined, live-birth rates were similar (70% vs. 71%), with serious adverse events less frequent in the IUI group (6 vs. 14 couples).

Lucy R Prentice, Lynn C Sadler, Karyn L Anderson, Jack D Wilkinson, Melissa A Vercoe, Sarah F Lensen, Elizabeth J Glanville, Sarah A Wakeman, Leigh M Searle, Cynthia M Farquhar

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In Vitro Fertilization or Intrauterine Insemination in Unexplained Infertility.

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