A related editorial comments on this research. The data from this study will be useful to fertility services. It seems clear that clinics should offer ovulation induction for 12 months. The decision of gonadotropins or clomifene citrate can be made on cost and convenience. The use of gonadotropins involves administration by injection, increased monitoring, and higher cancellation rates. Clomifene citrate is simpler to administer. It is clear from the M-OVIN study that there is little benefit in the addition of intrauterine insemination to clinical protocols for women on ovulation induction for normogonadotropic anovulation. Ultimately, patients should be given the choice after carefully weighing up the evidence. If there is one thing to take away from this study, it is to offer up to 12 cycles of ovulation induction in women with normogonadotropic anovulation before offering assisted reproductive technology.
Current NICE CG156 – (Fertility problems: assessment and treatment) currently recommends not extending clomifene citrate for more than six cycles.