Efficacy of intrauterine insemination without ovarian hyperstimulation formale or cervical factor in women aged 40 or over

The efficacy of intrauterine insemination (IUI) for male or cervical factor by age of female partner was determined in a retrospective analysis. Patie nts who underwent IUI therapy for cervical and/or male factor (n = 281) wer e classified by age at first IUI cycle: <40 years (n = 232), greater than o r equal to 40 years (n = 49). The indication for IUI was cervical factor if a postcoital test failed to show sperm with good forward progression at ti me of mature follicle; male factor was diagnosed if the semen analysis demo nstrated either low count, low motility, antisperm antibodies, or subnormal hypoosmotic swelling test. Intrauterine insemination was performed in eith er natural cycles or following ovarian stimulation for the treatment of ano vulation or follicular maturation defects. Cumulative probability of ongoin g pregnancy (viable at end of first trimester) following 3 cycles of IUI wa s evaluated. Cumulative probability of ongoing pregnancy following 3 cycles of IUI was 28.2% for the younger group and 0.0% for the older group. The a ge groups did not differ in terms of infertility history, use of ovarian st imulation, or baseline semen parameters. Thus, the treatment of male and/or cervical factor by IUI is ineffective for women greater than or equal to 4 0 years.