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. 2020 Mar 3;2020(3):CD001838. doi: 10.1002/14651858.CD001838.pub6

Chung 1995.

Methods Trial design: parallel
 Single centre, UK
Participants Couples with unexplained subfertility
N randomised: 100
 Age: IUI + OH 31.8 years (± 3.1); TI + OH 32.1 years (± 4.0)
 Duration of subfertility: IUI + OH 4.7 years (± 2.0); TI + OH 5.3 years (± 2.6)
 Basic fertility work‐up normal and semen 15 million motile per ejaculate
 Previous treatment: not stated
Interventions Comparison: IUI + OH versus TI + OH
 Stimulation method: FSH 150 IU/day and GnRH nasal spray from day 21 on
 Ovulation: 5000 IU hCG when < 4 follicles > 16mm
 hCG post‐ovulatory for luteal support
 Timing TI: 24 hr + 48 hr after hCG
 Timing IUI: 36 hr to 48 hr after hCG
 Duration of treatment: 3 cycles max
Outcomes PR per couple and per cycle
 Total delivered
 Multiple pregnancies
 Ectopic
 Miscarriage rate
Notes ITT analysis: possible
 IUI was not possible on Sundays
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Blocked randomisation scheme
Allocation concealment (selection bias) Low risk Adequate; numbered sealed envelopes
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Blinding was not possible because of the nature of the interventions
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Blinding was not possible because of the nature of the interventions and non‐blinding was not likely to affect the outcomes of interest
Incomplete outcome data (attrition bias) 
 All outcomes Unclear risk 8/50 withdrawn and 6 treatment cycles cancelled in TI group, 4/50 withdrawn and 11 treatment cycles cancelled in IUI group. Reason for cycle cancellation was excessive response. Reason for withdrawal was not stated
Selective reporting (reporting bias) Low risk Live birth data and complication numbers were reported
Other bias Low risk Nothing detected