Lay summary
In NZ public funding for infertility treatments is extremely limited. Couples with unexplained infertility wait five years to become eligible and then wait 12 months or more for treatment. Eligible couples are offered two packages of treatment and can choose from the following options; either four intrauterine insemination (IUI) cycles (washed sperm placed into the uterus) or one IVF cycle (embryos made in the laboratory by mixing eggs with sperm).; or two IVF cycles; or eight IUI cycles. IUI is immediately available and considerably cheaper, however few couples choose it and few physicians recommend it. One reason for this is inadequate evidence of effectiveness.
This randomised controlled trial will compare the cumulative live birth rate (CLBR) and costs of four IUI cycles with one IVF cycle. The trial will continue to completion of public treatment and compare CLBR and cost of IUI before two IVF cycles with two cycles of IVF.