Clomiphene citrate with intrauterine insemination: is it effective therapy in women above the age of 35 years?

Sanjay K. Agarwal, Richard P. Buyalos
In: Fertility and Sterility · 1996 · vol. 65(4) , pp. 759–763 · doi:10.1016/s0015-0282(16)58210-7 · PMID:8654635 · W2402499374
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This paper investigated the effectiveness of clomiphene citrate combined with intrauterine insemination for women over 35 years old seeking fertility treatment.

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Abstract

ObjectivesTo evaluate the influence of female age on clomiphene citrate (CC) with IUI therapy and to compare the efficacy of this therapy between patients with ovulatory and anovulatory infertility.SettingA university fertility clinic.SubjectsSix hundred sixty-four CC with IUI cycles from 290 women aged 22 to 48 years.Main outcome measuresCumulative and clinical pregnancy rates (PRs).ResultsBoth cumulative and clinical PRs declined substantially in women > 35 years when compared with those < or = 35 years. In addition, no difference in these parameters was noted between patients with ovulatory and anovulatory infertility diagnoses. The vast majority of pregnancies occurred within the first four treatment cycles, irrespective of age or ovulatory versus anovulatory infertility diagnoses.ConclusionsThe age-related decline in clinical PR is most rapid beginning at the age of 35 years. For any given age group, CC with IUI therapy has similar cumulative and clinical PRs for both ovulatory and anovulatory infertility diagnoses. This therapy usually should not extend beyond four cycles. Couples should be counseled about the dramatic fall in PRs occurring beyond the age of 35 years.

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