Conversion to IUI versus continuance with IVF in low responder patients: A systematic review

Publication date: August 2018 Source:European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 227 Author(s): Dennis T. Fujii, Jodi L. Quesnell, Ryan J. Heitmann Poor response to ovarian hyper-stimulation can be difficult to predict prior to stimulation even when factoring in patient age and ovarian reserve testing. When faced with the situation of poor response, patients and providers have the difficult decision to proceed with oocyte retrieval, convert to intrauterine insemination (IUI), or cancel the cycle. Although this is not an uncommon scenario, there is little data available to assist with the counseling of these patients. We performed a systematic review of published studies comparing clinical pregnancy and live births between those patients continuing with in-vitro fertilization (IVF) and those converting to IUI. PubMed and Ovid were searched for all retrospective and randomized studies using the Keywords ‘in-vitro fertilization’, ‘intrauterine insemination’, ‘poor responders’, ‘clinical pregnancy’ and ‘live birth rates’. A total of seven retrospective studies and one randomized control trial were reviewed. When evaluating poor responders as a group, six studies reported higher overall clinical pregnancy rates and five studies reported overall increased live birth rates with continuance of IVF. When stratified by the number of follicles produced, continuance of IVF demonstrated higher clinical pregnancy and live bi...

Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - June 8, 2018 Category: OBGYN Source Type: research