Fertility treatments offered to couples trying for a baby are no more effective than attempts to conceive naturally, a study suggests today.

Couples who attempt artificial insemination or use a drug designed to aid conception do not have significantly higher chances of a pregnancy than those not receiving treatment, the researchers found.

One in seven couples in Britain experiences problems conceiving, with about a quarter of these having unexplained infertility.

Treatments are offered in line with fertility guidelines issued by the National Institute for Health and Clinical Excellence (NICE). They include artificial insemination, and the drug clomiphene citrate, which is believed to correct subtle ovulatory dysfunction. Such treatments are relatively inexpensive and do not involve stimulation of a woman's ovaries or IVF (in vitro fertilisation).

Researchers writing in the British Medical Journal, however, have thrown into question the provision of such treatments on the NHS. Intrauterine insemination (IUI) and clomiphene citrate (Clomifert or Clomid) are recommended for couples who have had difficulty conceiving, but where investigations have failed to find out why. Couples would typically be offered these methods before considering IVF, which involves collecting a woman's eggs, fertilising them outside the body and returning them to her womb.

For the study, 580 women who had been trying unsuccessfully to conceive for more than two years were recruited from four teaching hospitals and one general hospital in Scotland. One group of 193 women were given advice on having sex regularly but were left to try to conceive naturally. Another 194 women were given clomifene. The remaining 193 were given IUI, which is thought to enhance the chance of pregnancy by injecting sperm behind the cervical barrier. All treatments were followed for six months.

At the end of the study, there had been 101 live births - 32 among the 193 women trying to conceive naturally (17 per cent), 26 among those on the drug (14 per cent) and 43 among those having insemination (23 per cent).

The researchers, from the universities of Aberdeen and Oxford, and hospitals in Edinburgh, Dundee, Falkirk and Glasgow, said that these differences were not significant enough to be attributed solely to treatment or lack of it. They suggested that the NHS could be wasting time and money on providing the therapies and called for the NICE guidelines to be reviewed.

Siladitya Bhattacharya, Professor of Reproductive Medicine in Aberdeen, who led the study, said that it was difficult to estimate how many women currently used IUI or clomifene citrate treatments, but added that it must be “hundreds of thousands”.

NICE endorses the use of up to six free cycles of IUI without ovarian stimulation in couples with unexplained infertility. Thousands of couples are being denied the three free cycles of IVF recommended by NICE as an advanced treatment, largely because of the expense. Figures from the Department of Health showed in June that nine out of 151 primary care trusts in England provided three cycles of IVF, leaving many patients to pay up to £2,000 per cycle for private treatment.

NICE said that the fertility guidance published in 2004 set “clear standards by outlining which types of treatment offer couples the best chance of conceiving, based on the best available evidence from around the world”.

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