Data from: Intrauterine insemination: a United Kingdom survey on the adherence to NICE clinical guidelines by fertility clinics

Objective: To evaluate the awareness and response of fertility clinics in the United Kingdom to the NICE guideline recommendation that intrauterine insemination (IUI) should not be routinely offered, in order to report on current practice in the United Kingdom. Design: Online questionnaire survey of fertility clinics in the United Kingdom regarding their current clinical practice of IUI, formal discussion of the guideline recommendations and any alterations made since the recommendations. Setting: Sixty-six United Kingdom fertility clinics licensed to provide IUI. Participants: Forty-six fertility clinics, including six clinic groups which represent seventy percent of all clinics and clinic groups licensed to provide IUI in April 2014 when the survey email was sent. Results: Of the forty-six clinics who responded, ninety-six percent (44/46) of clinics continue to offer IUI. Ninety-eight percent (43/44) of those offering IUI also use ovarian stimulation. The most commonly used medications for ovarian stimulation are gonadotrophins (96%), followed by clomiphene citrate (49%) and letrozole (19%). Seventy-eight percent (36/46) of clinics had formally discussed the NICE guideline recommendations. Seventeen clinics (37%) had made some changes to their practices; as a result four clinics reported a reduction in the number of IUI cycles, six clinics had restricted the indications for IUI and five clinics had begun informing patients of the guideline recommendations and two did not specify. Conclusion: The majority of clinics were aware of the guideline recommendations. However, only a small proportion of clinics had made significant changes to their practice by reducing the number of IUI cycles or restricting the clinical indications for IUI. The availability of further evidence will assist NICE and clinicians in making recommendations on the use of IUI. There is a need to further explore the reasons for the lack of adherence to the recommendations.