Success Rate of Inseminations Dependent on Maternal Age? An Analysis of 4246 Insemination Cycles

Abstract

!Intrauterine insemination (IUI) has latterly become less important in reproductive medicine. The aim of this retrospective analysis was to identify and evaluate the success rates of repeated insemination cycles in women of different ages. All women who underwent intrauterine insemination in the Wiesbaden Fertility Clinic between 1998 and 2010 were included in the analysis. Additional inclusion criteria were: not more than 45 years old, previous FSH stimulation and slight to moderate subfertility of the male partner. A total of 4246 insemination cycles in 1612 patients were included in the analysis. The average number of IUI cycles per patient was 2.24 (1-14). Patient age ranged from 19 to 45 years (mean: 33.9 years). Logistic regression analysis showed a drop in pregnancy rates with increasing age (p = 0.000). However, for the first three cycles the pregnancy rates for women aged 40 and 41 did not differ from those of women aged between 35 and 39 years. Overall pregnancy rates were stable in women up to the age of 40, even after several insemination cycles (7.5 and 10%). Insemination is therefore still an effective procedure in selected patients. Stable pregnancy rates were recorded even after more than 3 cycles. After 3 cycles, the success rates for women aged 40 and 41 did not differ from those of women below the age of 40.

The long-term prognosis for live birth in couples initiating fertility treatments

“…A Dutch study, with a cohort of 946 couples, found that 51% had a live birth and that 28% had a naturally conceived pregnancy (Donckers et al, 2011). Cumulated pregnancy rates of 25-30% after four IUIcycles, in women under 35, are previously reported in two smaller, single center studies from Korea and Germany (Jeon et al, 2013;Schorsch et al, 2013). A randomized trial from the Netherlands compared birthrates after a maximum of six fresh cycles of IVF or six cycles of IUI in couples with idiopathic or male subfertility (Goverde et al, 2000).…”

“…dk). IUI is a well-tolerated and inexpensive alternative to ART, but it is also known to be less efficient per treatment cycle (Goverde et al, 2000;Steures et al, 2007;Jeon et al, 2013;Schorsch et al, 2013). Only a few smaller studies have investigated the long-term prognosis for live birth after ART and IUI (Sundström et al, 1997;Pinborg et al, 2009;Donckers et al, 2011;Aanesen and Westerbotn, 2014).…”

Three-Dimensional HyCoSy With Perfluoropropane-Albumin Microspheres as Contrast Agents and Normal Saline Injections Into the Pelvic Cavity for Morphological Assessment of the Fallopian Tube in Infertile Women

“…This prospective study was performed for the primary or secondary infertility patients who planned to undergo timed intercourse or intrauterine insemination at the Department of Assisted Reproduction of the Ninth People's Hospital of Shanghai Jiaotong University School of Medicine, as a result of failure to achieve pregnancy for at least one year without any birth control between December 2013 and June 2014. Patients eligible for participation in the study had to meet the following criteria: The women had regular menstrual cycles with normal ovulation and their husbands' total sperm count was at least 10 million/mL with a motility of at least 35% . Those women who had any systemic disease, active pelvic infection, follicle‐stimulating hormone greater than 15 IU/L, number of follicles fewer than 5, severe endometriosis (stage III and IV), or their husbands had asthenospermia and oligospermia were excluded from this study.…”

“…Patients eligible for participation in the study had to meet the following criteria: The women had regular menstrual cycles with normal ovulation and their husbands' total sperm count was at least 10 million/mL with a motility of at least 35%. 18 Those women who had any systemic disease, active pelvic infection, follicle-stimulating hormone greater than 15 IU/L, number of follicles fewer than 5, severe endometriosis (stage III and IV), or their husbands had asthenospermia and oligospermia were excluded from this study. All women were scheduled to receive 3D HyCoSy with normal saline injected into the pelvic cavity for the assessment of the patency of fallopian tubes and adhesions of the fimbriae.…”

Evidence-Based Care for Couples With Infertility

“…Most patients are offered in vivo or in vitro treatment plans, and typically after implementation different procedures are selected based on the couple's diagnosis and previous treatment. In vivo fertilization cycles have a 5% to 15% success rate depending on the age of the woman (Schorsch et al, 2013). In the United States, the success rate or live birth rate for couples undergoing IVF is approximately 29% (CDC, 2015).…”