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When is clomiphene or gonadotropin intrauterine insemination futile? Results of the Fast Track and Standard Treatment Trial and the Forty and Over Tre
Conclusion(s): Women who initiated infertility treatment with FSH of 1015 mIU/mL and E2 ≥:40 pg/mL on day 3 testing were unlikely to achieve live birth after COH-IUI treatment.
175. Key indicator for successful treatment of infertile couples [Forum/Discussion]
from: Administrator (office@fertaid.com), Australia on 6/03/2015 11:49:45 AM Profession:
Comment: Women with an elevated FSH are unlikely to conceive using IUI/AIH but likely to conceive using IVF so why offer IUI?
Submission: No one wants to use IVF and many like the idea that more passive treatments are better. No one can argue with this since the conceptions are more natural than IVF (but still not the same as a spontaneous conception). Indeed, many criticise clinics who only offer IVF for not providing low cost options. However, there are some couples who in using IUI may be doing themselves a disservice and incorrectly believe this route is worthwhile. This study by Kaster, et. al (2015) identified an elevated FSH concentration of more than 10IU/L as a good indicator of failure using IUI even though they also were exposed to ovarian stimulation. This group had NO pregnancies after COH/IUI. Indeed, there is a good argument that offering IUI to poor prognosis clients without counselling about lack of success is poor management since it deprives the clients of valuable months to pursue IVF where the chance of pregnancy is better because their ovarian reserves are age dependent. An additional aspect is not the age to first conception but the age at last conception. By using many months with IUI, a clinic may be using up valuable months that in a few years hence when they may be trying for a second child. In IVF, few think about families, only pregnancy. But when you ask a couple, it is all about families. So any couples having treatment that offers poor prognosis should be receive counselling about the consequences of reducing the time for them to achieve a family.
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