Findings on Age and Treatment Plans: IVF vs IUI

We all know how difficult it is to decide whether to trust a relatively new fertility doctor when he or she wants to tell us bad news about IVF vs IUI success rates.

A 2012 study might help shed light on the numbers behind those cautionary tales.

Researchers from Shady Grove Fertility Reproductive Science Center presented studies at the 68th annual ASRM convention indicating that, for women aged 38 to 44, IVF might be more effective than IUI for women with unexplained infertility.

They reviewed 7,602 IVF cycles in 4,017 women aged 21 to 46. Pregnancy was 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 that age, however, the pregnancy rate was significantly lower.

The test looked at patients who received Clomid or other stimulation for IUI. After the first cycle, 40 percent of the patients (who were part of couples) who did not conceive stopped IUI; 20 percent went on to more than three unsuccessful cycles; five had more than six cycles; one couple had more than seven.

After six cycles for women under 40, the ongoing pregnancy rate ranged from 47% to 65%. But for women over 40, the ongoing pregnancy rate only reached 24 percent.

A retrospective study found that women aged 38 to 44 had much higher clinical and live birth rates after IVF than IUI. They 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 who were receiving stimulation treatment. Among these older women, “IVF treatment resulted in pregnancy and birth rates approximately 2.5 times higher than that achieved through IUI treatment.”

It may well be that IVF — more expensive, certainly, and more invasive — might be a more efficient method to conception than IUI, in general, for women over the age of 38. Please talk to your reproductive endocrinologist about this (for women over 38, it is recommended that an RE be consulted, beyond care provided by your ob/gyn).

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  2 comments for “Findings on Age and Treatment Plans: IVF vs IUI

  1. Johanna
    February 25, 2014 at 2:13 am

    Interesting. But, I think that many of the women on this site don’t have “unexplained infertility”, rather, it’s a lack of the sperm component that drives us to look for other answers, so seeing stats relating to couples trying to conceive become somewhat irrelevant to us. I’m checking out the yahoo groups for moms over 40 and have been greatly helped by that. Also, I am using Shady Grove for my next step (my insurance finally came in step with single women and will co-pay 50% of my attempt), and I’m happy that they are involved in the public education aspect, but (having met with them several times) I’d be more interested to find out whether their REs are partners who are more focused on success rates for their books rather than working with individuals’ desires as to how they want to go about their initial entrees into this new phase of our family planning. They seem to push for more aggressive approaches and I’m not clear on whether that is a function of them wanting to increase their success rates at any cost (to me) or whether I’m just kidding myself that I may still be able to do things my (IUI) way. I guess we’re about to find out!

    • Mikki
      February 25, 2014 at 7:56 am

      Johanna: That is a question I’ve attempted to answer in the Choice Mom Guide to Fertility with a series of doctors… what is the infertility factor at clinics when you take out the variable of “lack of sperm”? The question tends to be answered with, “depends on the age of the eggs.” When other fertility factors are weeded out, including lack of sperm, what it generally comes down to is how robust is the remaining quality of eggs?

      Coincidentally, your comment came just as I was announcing my new fertility newsletter series, created in sponsorship with The Sperm Bank of California. The very first issue of the 6-page newsletter series is about Fertility Science, and includes a page about statistics related to what tests reveal about egg quality, age by age, based on a study done by two clinics in California.

      You can find this FREE issue here.

      — Mikki

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