Patients undergoing intrauterine insemination (IUI) with ovarian stimulation are at greater risk of multiple pregnancy.
One study reported that the multiple birth rates for patients undergoing IUI following ovarian stimulation were:
- 22% twins
- 4% triplets
- 3% quadruplets
Minimising the risks
To balance the risks of multiple pregnancy with the chance of a positive outcome, the following approach is recommended:
- Explain to patients the risks of multiple pregnancy associated with ovarian stimulation combined with IUI. Give details of the types of problems that accompany multiple pregnancies and multiple births (see What are the risks?).
- Follow up with written information.
- IUI in combination with ovarian stimulation should not be offered to couples where a male factor is the suspected cause of infertility, or where fertility is unexplained, in an attempt to minimise the risk of multiple pregnancy.
- Patients should be informed that clinics will not proceed with IUI treatment if an excess of follicles are produced.
See the NICE website for more information.