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Human Reproduction, Vol. 17, No. 9, 2320-2324, September 2002
© 2002 European Society of Human Reproduction and Embryology

Intrauterine insemination with frozen donor sperm. Pregnancy outcome in relation to age and ovarian stimulation regime

I. Ferrara1,2, R. Balet1 and J.G. Grudzinskas1,2,3

1 The Bridge Centre, 1 St Thomas Street, London, SE1 9RY and 2 Department of Obstetrics and Gynaecology, St Bartholomew's and The Royal London School of Medicine and Dentistry, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK

BACKGROUND: The success of intrauterine insemination with donor semen (IUI–DI) is likely to be influenced by a number of variables, including age and ovarian stimulation (OS) regime. METHODS AND RESULTS: A retrospective analysis of 1056 treatment cycles in 261 women (212 single heterosexuals and 49 lesbians) was conducted to assess the influence of these two variables on pregnancy outcome during IUI–DI. The overall pregnancy rate was 10.6%, being 18.5% for women <35 years, 11.9% in women 35–40 years and 5.4% in women >40 years (P < 0.05). The cumulative pregnancy rate (CPR) after eight cycles was 0.86, 0.51 and 0.32 respectively (P < 0.05). A total of 445 inseminations were performed following spontaneous ovulation, 360 following OS with clomiphene citrate (CC) and 251 with hMG, the pregnancy rate per cycle being 13, 7.2 and 11.2% respectively. There was no statistically significant difference in the pregnancy rate per cycle, CPR or multiple pregnancy rate in the three treatment groups. CONCLUSIONS: These results indicate that the use of OS with either CC or hMG in women without ovulatory dysfunction does not improve the pregnancy rate during IUI–DI. The only factor associated with reduced effectiveness of fertility treatment was age, confirming that IUI is a poor treatment option for women >40 years of age.

Key words: age/donor sperm/IUI/ovulation induction

3 To whom correspondence should be addressed at: Reproductive Physiology Laboratory, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK. E-mail: n.m.rosen{at}mds.qmw.ac.uk


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