000			02045cam a2200193 4500
001			NMDX6941
008			120401t2016 xxu||||| |||| 00| 0 eng d
100			_aBahadur, G.
240			_aHuman Reproduction
245			_aFirst line fertility treatment strategies regarding IUI and IVF require clinical evidence
260			_c2016
500			_aNMUH Staff Publications
500			_a31
520			_a<span style="font-size: 10pt;">The advent of intracytoplasmic sperm injection (ICSI) has contributed to a significant growth in the delivery of assisted conception technique, such that IVF/ICSI procedures are now recommended over other interventions. Even the UK National Institute for Health Care Excellence (NICE) guidelines controversially recommends against intrauterine insemination (IUI) procedures in favour of IVF. We reflect on some of the clinical, economic, financial and ethical realities that have been used to selectively promote IVF over IUI, which is less intrusive and more patient friendly, obviates the need for embryo storage and has a global application. The evidence strongly favours IUI over IVF in selected couples and national funding strategies should include IUI treatment options. IUI, practised optimally as a first line treatment in up to six cycles, would also ease the pressures on public funds to allow the provision of up to three IVF cycles for couple who need it. Fertility clinics should also strive towards ISO15189 accreditation standards for basic semen diagnosis for male infertility used to triage ICSI treatment, to reduce the over-diagnosis of severe male factor infertility. Importantly, there is a need to develop global guidelines on inclusion policies for IVF/ICSI procedures. These suggestions are an ethically sound basis for constructing the provision of publicly funded fertility treatments.</span>
700			_aOkolo, S.
700			_aAl-Habib, A
856			_uhttps://www.ncbi.nlm.nih.gov/pubmed/27076499
856			_uhttp://ferriman.wufoo.com/forms/journal-article-request/
999			_c75963 _d75963