Immobilization versus immediate mobilization after intrauterine insemination: A systematic review and meta-analysis

J Gynecol Obstet Hum Reprod. 2017 Dec;46(10):747-751. doi: 10.1016/j.jogoh.2017.09.005. Epub 2017 Sep 28.

Abstract

Introduction: The objective of this systematic review and meta-analysis was to investigate a possible association between immobilization and pregnancy rate in patients undergoing intrauterine insemination.

Material and methods: To ensure the quality of the methodology, the PRISMA criteria were met at all stages of the development of this meta-analysis. We searched the Cochrane Library, EMBASE, PubMed MEDLINE, ScienceDirect and reference lists of eligible studies from inception to March 2017, without any restriction. We also interviewed the ClinicalTrials.gov database for unpublished articles. Finally, we sought potentially eligible studies in meeting abstracts. Two reviewers independently extracted study characteristics and outcome data. Estimates were pooled using random effects models and sensitivity analyses. We selected studies that compared bed rest to immediate mobilization after intrauterine insemination. The primary outcome was the ongoing pregnancy rate per couple.

Results: Of 176 identified abstracts, four primary studies, all of them randomized controlled trials, met the inclusion criteria, including 1361 couples. The overall relative risk of ongoing pregnancy rate in bed rest versus immediate immobilization was 1.67 95% CI [0.86; 3.22]. The overall relative risk of the live birth rate was 1.11 95% CI [0.56; 2.20].

Conclusion: This systematic review and meta-analysis was not able to demonstrate that bed rest after intrauterine insemination effectively increases in pregnancy rate. For everyday practice, no specific strategy, bed rest or immediate mobilization, can be recommended at this time.

Keywords: Bed rest; Immediate mobilization; Immobilization; Intrauterine insemination; Pregnancy rate.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Bed Rest* / methods
  • Bed Rest* / standards
  • Bed Rest* / statistics & numerical data
  • Female
  • Humans
  • Immobilization* / methods
  • Immobilization* / standards
  • Immobilization* / statistics & numerical data
  • Insemination, Artificial* / methods
  • Insemination, Artificial* / standards
  • Insemination, Artificial* / statistics & numerical data
  • Pregnancy
  • Pregnancy Rate*