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Fertil Steril. 2010 Jun;94(1):144-8. doi: 10.1016/j.fertnstert.2009.02.040. Epub 2009 Apr 25.

Poor success of gonadotropin-induced controlled ovarian hyperstimulation and intrauterine insemination for older women.

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  • 1Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Abstract

OBJECTIVE:

To determine the success rates and utility of controlled ovarian hyperstimulation in conjunction with intrauterine insemination (COH/IUI) cycles in women aged 38-39 years versus women >or=40 years old.

DESIGN:

Retrospective cohort study.

SETTING:

Tertiary-care academic medical center.

PATIENT(S):

There were 130 women, 57 aged 38-39 years (42.6%) and 73 aged >or=40 years (57.4%), who underwent 262 IUI cycles (range 1-3 cycles per woman).

INTERVENTION(S):

Infertility treatments with gonadotropins and IUI.

MAIN OUTCOME MEASURE(S):

Clinical pregnancy rates and live birth rates stratified by age.

RESULT(S):

The most common infertility diagnosis was diminished ovarian reserve, which was found more frequently among women aged >or=40 years than among the slightly younger group. The age-specific groups were similar in their baseline characteristics and cycle parameters. Women who were 38-39 years old had an overall live birth rate of 6.1% per cycle, with no live births occurring after the second cycle, and women >or=40 years old had an overall live birth rate of 2.0% per cycle, with all births occurring in the first cycle.

CONCLUSION(S):

The efficacy of COH/IUI cycles significantly decreases with age, but women aged 38-39 years had reasonable success during the first two cycles. However, for women aged >or=40 years, no benefit after a single cycle of COH/IUI was observed. Women aged >or=40 years should be considered for in vitro fertilization after one failed COH/IUI cycle.

Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

PMID:
19394605
[PubMed - indexed for MEDLINE]
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