Ovulation induction combined with intrauterine insemination in women 40 years of age and older: is it worthwhile?

• Published in: Human reproduction (Oxford) Vol. 11; no. 5; pp. 1109 - 1112
• Main Authors: Corsan, G., Trias, A., Trout, S., Kemmann, E.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.05.1996
• Subjects: Adult; age; Biological and medical sciences; Birth control; Chorionic Gonadotropin - therapeutic use; Clomiphene - therapeutic use; Female; fertility; Gynecology. Andrology. Obstetrics; Humans; Infertility - therapy; Insemination, Artificial, Homologous; intrauterine insemination; Male; Maternal Age; Medical sciences; Menotropins - therapeutic use; Middle Aged; Ovulation Induction; Pregnancy; Pregnancy Outcome; Pregnancy, High-Risk; Retrospective Studies; Sterility. Assisted procreation; intrauterine insemination; age; ovulation induction; fertility; Human; Prognosis; Indication; Induction; Artificial insemination; Assisted procreation; Age 40-49; Female; Female sterility; Ovulation
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/oxfordjournals.humrep.a019306

The use of ovulation induction combined with intrauterine insemination (IUI) as a treatment for subfertility in women with patent Fallopian tubes has increased in recent years. Little is known regarding the efficacy of this treatment in women aged≥40 years. We reviewed our data in our ovulation induction with IUI programme for 168 consecutive patients aged ≥40 years undergoing a total of 469 cycles of treatment. Either sequential clomiphene citrate and human menopausal gonadotrophins or daily gonadotrophins were utilized along with timed IUI insemination. In 402 completed cycles, 28 clinical pregnancies occurred. The pregnancy loss rate was 34.4%. The overall ongoing/viable pregnancy rates per initiated and completed cycles were 4.47 and 5.22% respectively. No viable pregnancies occurred in 136 cycles in women aged ≥43 years. The ongoing/viable cycle fecundity rates for women aged 40, 41, and 42 years were 9.6, 5.2, and 2.4% percycle respectively. When utilized in women aged≥40 years, ovulation induction with IUI is most likely to result in successful pregnancy in women 40–42 years of age. Women≥43 years should consider other alternatives such as adoption or egg donation.