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Treatment Option Shortens Path to Pregnancy

Skipping one phase when treating infertility also cuts costs, study finds

FRIDAY, June 19 (HealthDay News) -- Among couples going to fertility clinics, pregnancy occurred more quickly -- and for less money -- when they took an accelerated route to in vitro fertilization, a new study has found.

The advantages came when the researchers eliminated one step in the fertility treatment -- the gonadotropin-stimulated intrauterine insemination cycle. Gonadotropin is a follicle-stimulating hormone.

Working with couples at Boston IVF and Harvard Vanguard Medical Associates, the researchers divided 503 couples into two groups. Women in one group underwent conventional treatment -- three cycles of intrauterine insemination (IUI) using clomiphene citrate to stimulate ovulation, followed by three gonadotropin-stimulated IUI cycles, then up to six cycles of in vitro fertilization (IVF).

IUI is a procedure in which a thin, flexible catheter is threaded through the cervix and used to inject washed sperm directly into the uterus. In IVF, egg and sperm are joined outside the uterus in a petri dish, and the fertilized egg is then placed into the uterus.

Women in the other group went straight from the three clomiphene citrate-stimulated IUI cycles to the IVF cycles.

For women who skipped the gonadotropin-stimulated IUI cycle (also called FSH-stimulated cycle), the average time to pregnancy was eight months, compared with 11 months for those on the lengthier, conventional fertility-treatment program.

The study also found that the average delivery charges, based on insurance data, were $9,800 lower for those in the accelerated group and that couples saved, on average, $2,624, the study reported.

Women in the accelerated group were less likely to have multiple births, which helped lower the cost, according to the study.

Overall, 64 percent of the women, who ranged in age from 21 to 39, had a baby. That included 171 of 256 in the accelerated program and 150 of 247 in the lengthier program.

The study appears online June 16 in Fertility and Sterility.

"This is a very important study that will likely influence physicians to reduce the number of stimulated inseminations for patients with unexplained infertility," Elizabeth Ginsburg, president of the Society for Assisted Reproductive Technology, said in a news release from the group. "Adoption of such an accelerated course of treatment could result in many patients conceiving in less time with less expense."

More information

The American Pregnancy Association has more on in vitro fertilization.

SOURCE: American Society for Reproductive Medicine, news release, June 15, 2009

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