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Clinical Trial Shows that Going to IVF after Fewer Artificial Insemination Cycles Results in a Shorter Average Time to Pregnancy
ASRM, 17 October 2007
Washington, DC- Today at the 63rd Annual Meeting of the American Society for Reproductive Medicine, Dr. Richard Reindollar presented the results of a randomized clinical trial showing that an accelerated treatment track for unexplained infertility results in just as many patients becoming pregnant but in a shorter period of time, compared with the conventional treatment series.
Five hundred and three couples with unexplained infertility (12 months trying to conceive, no pelvic pathology, normal semen analysis, and normal ovarian reserve) were randomized to two groups: one embarked upon the conventional series of treatments involving three cycles of intrauterine insemination (IUI) with clomiphene for ovulation induction, followed by another three cycles of IUI with FSH stimulation, followed by up to six cycles of IVF. The other group’s treatment series was accelerated by skipping the second round of IUI with FSH and going straight to IVF if the IUI with clomiphene stimulation did not result in a pregnancy.
In the conventional group, 43/232 of the women became pregnant in the clomiphene IUI round; 43/170 became pregnant from FSH-IUI; and 71/111 became pregnant after IVF. A total of 157 clinical pregnancies were achieved in up to 12 treatment cycles.
In the accelerated group, 50/242 became pregnant in a clomiphene cycle and 117/171 became pregnant after IVF. This resulted in 167 pregnancies in up to nine treatment cycles.
Additional data will be presented at the meeting on per cycle pregnancy rates, the probability of pregnancy and estimates of time to biochemical and clinical pregnancy for each treatment regimen.�
Steven J. Ory, MD, President of the American Society for Reproductive Medicine commented, “These results point out some of the problems inherent in treating unexplained infertility. Some patients respond better to certain medications and protocols than others, and you have to balance the invasiveness of the approach against its effectiveness. Using an accelerated treatment program, like the one this group devised could greatly benefit many patients by helping them conceive in a shorter time.”
O-108, Reindollar et al, A randomized controlled trial of 503 couples assigned to conventional infertility treatment or an accelerated track to IVF: preliminary results of the fast track and standard treatment (FASTT) trial.
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