title: Ovarian stimulation and intrauterine insemination in women aged 40 years or more.
abstract: Fertility decreases with advancing age. This study retrospectively reviewed the results of ovarian stimulation and intrauterine insemination (IUI) in women 40 years old with diminished ovarian reserve or unexplained infertility who underwent treatment with ovarian stimulation/IUI with clomiphene citrate or gonadotrophin and compared them with the results of IVF and in-vitro maturation (IVM) treatments. The main outcome measures were pregnancy and live-birth rates. The profiles of the patients in ovarian stimulation, IVM and IVF groups were comparable. There were no clinical pregnancies in the clomiphene citrate and IVM groups. The clinical-pregnancy rates in the gonadotrophin and IVF groups were 2.6% and 16.9% and the live-birth rates were 2.6% and 13.7%, respectively. Compared with ovarian stimulation, IVF is most effective for women aged 40 years or more. Attempting success with ovarian stimulation or IVM will delay conception unnecessarily.
authors.affiliation: Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada. wiserniv@netvision.net.il
authors.forename: Amir
authors.initials: A
authors.lastname: Wiser
authors.forename: Einat
authors.initials: E
authors.lastname: Shalom-Paz
authors.forename: Shauna Leigh
authors.initials: SL
authors.lastname: Reinblatt
authors.forename: Weon-Young
authors.initials: WY
authors.lastname: Son
authors.forename: Mausumi
authors.initials: M
authors.lastname: Das
authors.forename: Togas
authors.initials: T
authors.lastname: Tulandi
authors.forename: Hananel
authors.initials: H
authors.lastname: Holzer
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D015181:Gamete Intrafallopian Transfer; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000628:therapy*; D008423:Maternal Age; D008596:Menotropins / Q000627:therapeutic use; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies
chemical_list: D002996:Clomiphene; D008596:Menotropins; D005640:Follicle Stimulating Hormone