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).