18 October 2018
Study into fertility treatment’s benefits wins Liley medal for breakthrough research
An Auckland academic and fertility specialist whose research could revive support for a fertility treatment that’s less
invasive than IVF, has just received a top honour from the Health Research Council of New Zealand (HRC).
Professor Cynthia (Cindy) Farquhar, postgraduate professor of Obstetrics and Gynaecology at the University of Auckland
and consultant clinician at Fertility Plus and National Women’s at the Auckland District Health Board, was last night
awarded the'HRC’s prestigious Liley Medal at the Royal Society Te Apārangi 2018 Research Honours Aotearoa held at Te
The Medal recognises her study into Intrauterine Insemination (IUI), published in The Lancet last November.
In a clinical trial, Professor Farquhar showed for the first time that IUI (a medical procedure to place sperm in the
uterus) combined with ovarian stimulation (with either clomiphene or letrozole medication) was three times more
effective than trying to conceive naturally in women with unexplained infertility and an unfavourable prognosis for
Though IUI is widely used in New Zealand, the UK, USA and Europe as a less-invasive and less expensive alternative to
in-vitro fertilisation (IVF), before now there had been little evidence of its success rate compared to ‘expectant
management’ (when couples are advised to be sexually active around the likely time of ovulation for a chance of
conceiving naturally). Consequently, in 2013 the UK National Institute for Health and Care Excellence (NICE) recommended
that IUI should not be routinely offered for couples with unexplained infertility.
Professor Farquhar says the NICE recommendation will now be reconsidered as a result of her team’s findings which prove
that the treatment is worth continuing.
In the trial, 101 women receiving IUI treatment had 31 live births, compared with 9 live births for the 100 women
assigned to ‘expectant management’. The study concluded that IUI could be offered as a safe and effective first-line
strategy for couples with unexplained infertility.
Professor Farquhar credits the breakthrough to the medication giving couples a helping hand by enabling more eggs to be
released, and timing conception right by getting sperm into the uterus and thus halfway to the egg.
She adds that IUI offers a simpler type of fertility treatment than IVF, which is more complicated but thought by many
to be more effective.
In New Zealand, couples with unexplained infertility who are eligible for publicly-funded fertility treatment have the
option of either one cycle of IVF-type treatment (or microsurgery on the fallopian tubes or testes if that’s more
appropriate than IVF) or four cycles of IUI treatment. The next step for Professor Farquhar is to test the effectiveness
of four cycles of IUI compared with IVF, to help determine the most effective first-line treatment for couples to
The HRC’s chief executive, Professor Kath McPherson, says it’s imperative to keep testing and building the evidence that
underpins clinical practices. “Professor Farquhar’s study has provided evidence in a field where less invasive, more
successful, and more affordable treatment options are very much needed.
“These findings are a significant advance in knowledge that could inform healthcare going forward, and help couples make
better-informed decisions about treatment,” she says.
Professor Farquhar has over 280 peer-reviewed publications. She is the past Chair of the
Perinatal and Maternal Mortality Review Committee and currently coordinating editor of the Cochrane Gynaecology and
Fertility Group as well as lead methodologist for the World Health Organization Fertility Guidelines in 2018-2019.