Unlocking fertility success: A comprehensive exploration of age and intrauterine insemination outcomes

Abstract

Background: The success of intrauterine insemination (IUI) can be influenced by multiple factors, extending beyond age and the number of treatment cycles. Objectives: This study aims to conduct a thorough analysis of 466 IUI treatment cycles performed on 221 patients at a fertility center within a university hospital between 2021 and 2023. Methods: A retrospective review of medical records was conducted, encompassing 466 IUI treatment cycles performed on 221 patients at a university hospital's fertility center from 2021 to 2023. Female patients were categorized into three age groups: below 35 years old, between 35 and 40 years old, and over 40 years old. The study evaluated multiple outcomes, including rates of biochemical pregnancy, clinical pregnancy, live births, and miscarriages. A Kaplan-Meier analysis was employed to assess treatment cycle success within each age group. Results: The average age of the patients was 35.2 years, ranging from 21 to 49 years. The overall rate of biochemical pregnancy was 69.6%. Biochemical pregnancy rates significantly declined with increasing female age, with rates of 45.6% for those below 35 years old, 39.8% for those aged 35 to 40 years, and 34.1% for those over 40 years old (p = 0.002). However, there were no significant differences observed in other pregnancy outcomes across different age groups. The cumulative biochemical pregnancy rate increased up to four cycles in all age groups. Conclusion: It is recommended to consider up to four insemination cycles before proceeding to an IVF/ICSI cycle.