Comparison of outcomes of KOH/IUI and IVF treatment in advanced age infertile women

Year 2016, , 0 - 0, 24.02.2016

Selçuk Selçuk , Evrim Bostancı , Mehmet Küçükbaş , Bülent Bilgiç Hüseyin Kutlu Belgin Devranoğlu , Semra Eser

https://doi.org/10.16948/zktb.33976

Abstract

Objective: The aim of the study was to compare the outcomes of patients >38 years of age who underwent COH/IUI and those who underwent IVF treatment.

Material and Method: 113 patients who meet the inclusion criteria were enrolled into the study. Of the 113 patients; 42 patients who underwent KOH/IUI and 71 patients who underwent IVF treatment. The biochemical, clinical and ongoing pregnancy rates were compared between two groups.

Results: There were significant differences in terms of biochemical and clinical pregnancy rates between two groups and those were higher in IVF treatment (p1=0.033, p2=0.031). Ongoing pregnancy rate was higher in IVF treatment group but there was no significant difference between two groups (p=0.084).

Conclusion: IVF treatment may be first line treatment option in advanced age women because of the higher success rates of IVF treatment than COH/IUI treatment.

Keywords

In vitro fertilization, intrauterine insemination, advanced age

İleri yaş infertil kadınlarda KOS/IUI ile IVF tedavilerinin sonuçlarının karşılaştırılması

Abstract

Amaç: Çalışmada 38 yaş üzeri infertil kadınlarda KOS/IUI ile IVF tedavilerinin sonuçlarının karşılaştırılması amaçlanmaktadır.

Gereç ve Yöntem: 38 yaş üzerindeki KOS/IUI veya IVF tedavisi alan toplam 113 infertil kadın bu retrospektif çalışmaya dahil edilmiştir. Çalışmada KOS/IUI tedavisi uygulanmış 42 hasta, IVF tedavisi uygulanmış 71 hasta bulunmaktadır. İki grup biyokimyasal gebelik, klinik gebelik ve devam eden gebelik sonuçları açısından karşılaştırıldı.

Bulgular: İki grup arasında biyokimyasal gebelik ve klinik gebelik oranları arasında istatistiksel olarak anlamlı düzeyde farklılık saptandı. Biyokimyasal gebelik ve klinik gebelik oranları IVF tedavisi alan grupta daha yüksekti (p1=0.033, p2=0.031). Devam eden gebelik oranı IVF tedavisi alan grupta daha yüksek olmasına rağmen iki grup arasında istatistiksel derecede anlamlı bir fark saptanmadı (p=0.084).

Sonuç: İleri yaş grubundaki hastalarda IVF tedavisi KOS/IUI tedavisinden daha etkin olması nedeniyle bu yaş grubundaki hastalarda ilk tedavi seçeneği olarak IVF tedavisinin uygulanabileceğini düşünmekteyiz.

Keywords

in vitro fertilization, intrauterine inseminasyon, ileri yaş

References

• Botting B, Dunnell K. Trends in fertility and contraception in the last quarter of the 20th century. Popul Trends. 2010;100:32–9.
• Bewley S, Davies M, Braude P. Which career first? BMJ. 2005;331:588–9.
• Menken J, Trussell J, Larsen U. Age and infertility. Science. 1986;233:1389–94.
• ESHRE Capri Workshop Group. Fertility and ageing. Hum Reprod Updat. 2005;11:261–76.
• Devroey, P., Godoy, H., Smitz, J., Camus, M., Tournaye, H., Derde, M.P., Van Steirteghem, A., 1996. Female age predicts embryonic implantation after ICSI: a case-controlled study. Hum. Reprod.11, 1324–1327.
• Hull, M.G., Fleming, C.F., Hughes, A.O., McDermott, A., 1996. The age-related decline in female fecundity: a quantitative controlled study of implanting capacity and survival of individual embryos after in-vitro fertilization. Fertil. Steril. 65, 783–790.
• Marcus, S.F., Brinsden, P.R., 1996. In-vitro fertilization and embryo transfer in women aged 40 years and over. Hum. Reprod. Update 2, 459–468.
• Magarelli C, Pearlstone C, Buyalos R. Discrimination between chronological and ovarian age in infertile women aged 35 years and older: predicting pregnancy using basal follicle stimulating hormone, age and number of ovulation induction/intra-uterine insemination cycles. Hum Reprod. 1996;11(6):1214–9.
• Harris, I.D., Missmer, S.A., Hornstein, M.D., 2010. Poor success of gonadotropin-induced controlled ovarian hyperstimulation and intrauterine insemination for older women. Fertil. Steril. 94, 144–148.
• Corsan G, Trias A, Trout S, Kemmann E. Ovulation induction combined with intrauterine insemination in women 40 years of age and older: is it worthwhile? Hum Reprod 1996;11:1109–12.
• Tsafrir, A., Simon, A., Margalioth, E.J., Laufer, N., 2009. What should be the first-line treatment for unexplained infertility in women over 40 years of age-ovulation induction and IUI, or IVF? Reprod. Biomed. Online 19, 4334.
• Tatone, C., Amicarelli, F., Carbone, M.C., Monteleone, P., Caserta, D., Marci, R., Artini, P.G., Piomboni, P., Focarelli, R., 2008. Cellular and molecular aspects of ovarian follicle ageing. Hum. Reprod. Update 14, 131–142.
• Frederick, J.L., Denker, M.S., Rojas, A., Horta, I., Stone, S.C., Asch, R.H., Balmaceda, J.P., 1994. Is there a role for ovarian stimulation and intra-uterine insemination after age 40? Hum. Reprod. 9, 2284–2286.
• Wiser A et al. Ovarian stimulation and intrauterine insemination in women aged 40 years or more. Reprod BioMed Online. 2012;24:170–3.
• Human Fertilisation and Embryology Authority (HFEA). Fertility treatment in 2010: trends and figures. London: HFEA; 2010.
• Tsafrir A, Simon A, Revel A, Reubinoff B, Lewin A, Laufer N. Retrospective analysis of 1217 IVF cycles in women aged 40 years and older. Reprod Biomed Online. 2007 Mar;14(3):348-55.