OVULATION INDUCTION COMBINED WITH INTRAUTERINE INSEMINATION IN WOMEN 40 YEARS OF AGE AND OLDER - IS IT WORTHWHILE

The use of ovulation induction combined with intrauterine insemination (IUI) as a treatment for subfertility in women with patent Fallopian tubes has increased in recent years. Little is known regarding the eff icacy of this treatment in women aged greater than or equal to 40 year s. We reviewed our data in our ovulation induction with IUI programme for 168 consecutive patients aged greater than or equal to 40 years un dergoing a total of 469 cycles of treatment. Either sequential clomiph ene citrate and human menopausal gonadotrophins or daily gonadotrophin s were utilized along with timed IUI insemination. In 402 completed cy cles, 28 clinical pregnancies occurred, The pregnancy loss rate was 34 .4%. The overall ongoing/viable pregnancy rates per initiated and comp leted cycles were 4.47 and 5.22% respectively, No viable pregnancies o ccurred in 136 cycles in women aged greater than or equal to 43 years. The ongoing/viable cycle fecundity rates for women aged 40, 41, and 4 2 years were 9.6, 5.2, and 2.4% per cycle respectively. When utilized in women aged greater than or equal to 40 years, ovulation induction w ith IUI is most likely to result in successful pregnancy in women 40-4 2 years of age. Women greater than or equal to 43 years should conside r other alternatives such as adoption or egg donation.