What Is The Best Infertility Treatment For Women 40 And Older?

Present treatment approaches to unexplained or age related infertility in women 40 years of age or older include ovarian stimulation coupled with intrauterine insemination or in-vitro fertilization. Counseling couples toward realistic expectations for success requires data which can be relied upon to convey the likelihood of pregnancy for each treatment option.  The couples decision is further complicated by the fact that one treatment option (ovarian stimulation coupled with intrauterine insemination) is often covered by health insurance while in-vitro fertilization is often not a covered expense.  A study by Wiser, Shalom-Paz, et.al., in press at the present time adds important information for couples who must choose from the available treatment options.  The live birth rates for the group stimulated with injectable pituitary hormones (gonadotropins) coupled with intrauterine insemination was 2.6% compared to 13.7% for the IVF group. The substantial advantage of IVF across all age groups has been well established in many studies.  This study clearly validates the advantages of IVF when the woman is 40 or older.  

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Dr. Louis R. Manara

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