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  Artificial insemination can work in older women

By: Unknown Author
Reuters, August 5, 2002


- Although more likely to be successful in younger women, artificial insemination is less pricey than other fertility treatments and can work for some women over 40, according to researchers.

Their study found that a similar percentage of women 40 to 42 years old became pregnant and delivered babies after undergoing intrauterine insemination (IUI), compared with women in their late 30s.

In IUI, a catheter is inserted through the cervix and sperm is injected directly into the uterus, either alone or after a woman has taken ovulation-stimulating drugs. Because the technique is believed to be most successful in younger women, older women often forego IUI in favor of more invasive and expensive assisted reproductive technology procedures, such as vitro fertilization.

But according to the study of more than 1,000 women, the likelihood of delivering a healthy baby remained fairly constant between age 36 and 42. For instance, the live birth rate per insemination for women aged 36 to 39 was 9.5%, compared with 8.5% for women 40 and older.

For women at least 43 years old, the live birth rate declined to about 4%, report researchers in the July issue of Fertility and Sterility.

In comparison, the live birth rate was about 26.7% per insemination for those under 25, 14.2% for women 25 to 29 and 12.5% for those aged 30 to 35.

One reason for the drop in live birth rate was that pregnancies in older women were more likely to end in miscarriage. The pregnancy rate with and without ovarian stimulation remained fairly steady between the ages of 30 and 40, ranging from about 20% per insemination in women aged 30 to 35 and 18% in women 40 and older. However, the miscarriage rate jumped from 36% in women in their early 30s to 53% in those over 40, Dr. Jeffrey Haebe from the University of Ottawa in Canada and colleagues found.

The study shows that while older age lowers the likelihood of becoming pregnant and delivering a healthy baby, IUI remains a viable option for some women over age 35, they conclude.

"It therefore is reasonable to include...IUI as a possible fertility treatment for couples with a female age of less than 43 years," the researchers write.

However, the study results may not reflect success rates for all women. The final tally did not include women who never underwent IUI because they did not produce a mature egg, or had too many eggs develop to undergo the procedure.

SOURCE: Fertility and Sterility 2002;78:29-33.

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