Open AccessAlternative strategies to in vitro fertilization/intracytoplasmic sperm injection treatment for aged infertile women
Author(s) -
Isono Wataru,
WadaHiraike Osamu,
Shirane Akira,
Fujimoto Akihisa,
Osuga Yutaka,
Yano Tetsu,
Taketani Yuji
Publication year - 2012
Publication title -
reproductive medicine and biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.005
H-Index - 22
eISSN - 1447-0578
pISSN - 1445-5781
DOI - 10.1007/s12522-011-0107-4
Subject(s) - intracytoplasmic sperm injection , medicine , gynecology , infertility , endometriosis , in vitro fertilisation , adenomyosis , obstetrics , pregnancy rate , fertility , pregnancy , reproductive medicine , assisted reproductive technology , population , biology , genetics , environmental health
Purpose This study aimed to maximize the chance of pregnancy and provide an optimal protocol for infertile female patients of advanced reproductive age as an alternative to in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment. Methods We retrospectively analyzed medical records of 432 infertile women aged ≥38 at the beginning of the treatment. Stepwise non‐IVF/ICSI treatments using timed intercourse or intrauterine insemination, with or without controlled ovarian stimulation, were adopted for all patients. In this population, we extracted 8 representative infertility factors and examined these effects on fertility rate by calculating clinical pregnancy rate. Results The prognosis for infertile women possessing at least one of the three factors, ‘advanced female age (≥42 years)’, ‘endometriosis/adenomyosis’, and ‘tubal infertility’ was apparently poor because only 5 out of 155 women were able to conceive (1.02% per cycle). In contrast, 95 patients without the four factors, ‘advanced female age’, ‘endometriosis/adenomyosis’, ‘tubal infertility’, and ‘male infertility’, were more likely to conceive (9.14% per cycle). Conclusions Fertility centers can offer appropriate protocols for non‐IVF/ICSI treatment and establish guidelines for aged infertile patients by examining infertility factors and considering their combinations.