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Female Patients’ Age Is an Important Consideration in Choosing Optimal Fertility Treatment

October 22 , 2012
by: ASRM Office of Public Affairs
Published in ASRM Press Release

Note: All information is embargoed until the time of presentation at the meeting, unless otherwise indicated.

HIGHLIGHTS FROM THE 68th ANNUAL MEETING OF THE AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE

Embargoed for Release: Monday, October 22, 2012 – 4:30 PM   Pacific Daylight Time

Female Patients’ Age Is an Important Consideration in Choosing Optimal Fertility Treatment

San Diego, CA - Researchers from the Shady Grove Fertility Reproductive Science Center will present studies at the 68th Annual Meeting of the American Society for Reproductive Medicine showing that the effectiveness of intrauterine insemination (IUI) for unexplained infertility falls off for women over the age of 40 and that, for women aged 38 to 44, IVF is more effective than IUI. 

A review of 7602 IUI cycles in 4017 women age 21-46 showed that pregnancy is established  at similar rates regardless of age in women undergoing Clomid or gonadotropin-stimulated IUI for unexplained infertility up to the age of 40.  After 40, however, the ongoing pregnancy rate is considerably lower.  For women over 40, more aggressive treatments, such as IVF may be considered to reduce their time to conception.

Patients who exclusively received Clomid or gonadotropin-stimulated IUI for a diagnosis of unexplained infertility were evaluated for ongoing pregnancy rate. The couples underwent an average of 1.5 cycles.  After the first cycle, 40% of couples who did not conceive stopped this treatment.  Twenty percent of couples went on to more than three unsuccessful cycles.  Five couples had more than 6 cycles; and one couple had more than 7. 

The cumulative ongoing pregnancy rate for all patients after six cycles reached 48% with a per cycle range of 5-19%.  After six cycles for women under 40, ongoing pregnancy rate ranged from 47% to 65%, for women over 40, the cumulative ongoing pregnancy rate only reached 24%.

O-8 Clomid-Gonadotropin Ovarian Hyperstimulation and Intrauterine Insemination: Efficacy with Multiple Cycles
Cox et al

 
A retrospective cohort study found that clinical pregnancy and live birth rates among women aged 38 to 44 are much higher after IVF than IUI.  Researchers examined 3,653 IVF cycles and 2,717 IUI cycles performed for women age 38 to 44 diagnosed with unexplained infertility or diminished ovarian reserve and receiving gonadotropin stimulation.   Among older women (age 38-44), IVF treatment resulted in pregnancy and birth rates approximately 2.5 times higher than that achieved through IUI treatment.  

Brad Van Voorhis, MD, President of the Society for Reproductive Endocrinology and Infertility, said, ”While intrauterine insemination may be a less invasive treatment, there are definite advantages to IVF for women in their later reproductive  years who are experiencing unexplained infertility.  The age related decline in fertility leaves women in this age group with less time to have their children.  This study shows that IVF, although more demanding, is a more efficient treatment for them.”

O-258 In Vitro Fertilization (IVF) Yields Much Higher Success Rates Than Intrauterine Insemination (IUI) Among Older Women Aged 38-44 Years
C. M. Eguiguren et al.


The American Society for Reproductive Medicine, founded in 1944, is an organization of more than 7,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.  Affiliated societies include the Society for Assisted Reproductive Technology, the Society for Male Reproduction and Urology, the Society for Reproductive Endocrinology and Infertility, the Society of Reproductive Surgeons and the Society of Reproductive Biologists and Technologists.

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