Factors affecting success of intrauterine insemination: a 3 year prospective study

Abstract

Objective: The objective of the study is to evaluate the effect of female age on the outcome of ovarian stimulation (OS) and intrauterine insemination (IUI) treatment. Methodology: This was a 36 months' retrospective analysis of all IUI treatment cycles with prior OS. Based on the age of the women, 4 groups were identified for comparative analysis, namely women below 30 years, between 30 and 34; 35-39 years, and women aged 40 years and beyond. Results: Two hundred and seventeen IUI procedures were conducted during the study and 39 had a positive pregnancy test outcome (a pregnancy rate of 18%). Majority of the women were 35-39 years (41.5%), while 12% were 40 years and above. The pattern showed that the pregnancy rate was highest in the younger age group who were below 30 years, 6/18 (33.3%) and 30-34 years, 19/83 (22.9%) compared with women 35-39 years, 12/90 (13.3%) and >/=40 years, 2/26 (7.7%). The difference in the linear association of each age class compared to the next was significant (P = 0.06 and P = 0.007, respectively). The trend revealed that baseline follicle stimulating hormone increased with age and the youngest age group required significantly fewer units of human menopausal gonadotropin to achieve adequate response to OS compared to the oldest age group (P < 0.001). Conclusion: Advanced age negatively affects OS and IUI outcome. Treatment is associated with better pregnancy outcome in women under 35 years compared to women who were 40 years and beyond. This fact should be clearly emphasized at counseling of the 40-year-old that may opt for IUI treatment.