Influence of age, diagnosis, and cycle number on pregnancy rates with gonadotropin-induced controlled ovarian hyperstimulation and intrauterine insemination

Objective: To determine whether age, diagnosis, and cycle number influence cycle fecundity associated with gonadotropin-induced controlled ovarian hyp erstimulation/IUI. Design: Retrospective analysis. Setting: The Center for Reproductive Medicine at the Brigham and Women's Ho spital, a tertiary care academic medical center. Patient(s): Two hundred seventy-four women who underwent controlled ovarian hyperstimulation with gonadotropins and IUI. Intervention(s): Infertility treatment with gonadotropins and IUI. Main Outcome Measure(s): Pregnancy rates according to patient age, infertil ity diagnosis, and number of treatment cycles. Result(s): Pregnancy rates decreased with increasing patient age. The cumul ative pregnancy rates varied greatly by diagnosis from 13% for patients wit h male factor infertility to 84% for patients with ovulatory factor inferti lity. Average cycle fecundity was considerably less varied by diagnosis. Al l pregnancies among patients with male factor infertility and tubal factor infertility were achieved during the first two cycles. Conclusion(s): There is a clear age-related decline in fecundity associated with gonadotropin-induced controlled ovarian hyperstimulation/IUI. Patient s <40 years of age and those with male factor infertility or tubal factor i nfertility have a particularly poor prognosis. (Fertil Steril(R) 1999;72:50 0-4, (C) 1999 by American Society for Reproductive Medicine.).