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• W2080136715 abstract "ObjectivePublished studies in 1991 reported gonadotropin IUI and IVF live birth rates to be similar. Insurance companies in mandated states have used these prior studies to design criteria for IVF approval; today this often requires the patient complete at least three FSH/IUI cycles before IVF approval. Calculations of IUI versus IVF outcome and cost-effectiveness must incorporate timely pregnancy rates. SART reported an IVF pregnancy rate/retrieval of 15.2% in 1991 vs. 32.6% in 2002. This doubling of IVF pregnancy rates prompts re-evaluation of prior comparisons. This study reviews pregnancy rates in high-responding gonadotropin IUI cycles emergently converted to IVF. These converted cycles provide an initial comparison for fast track versus systematic treatment of patients, where cost and pregnancy outcome are to be considered.DesignA retrospective analysis of IVF and FSH/IUI data in 2004 in a private clinic in an insurance mandated state.Materials and methodsFour patient groups (divided into > and < 38 y.o.) were analyzed for delivery rates: 1) first time IUI cycles 2) total (1-3) IUI cycles; 3) IUI cycles emergently converted to IVF due to ≥ 5 mature follicles present after stimulation; and 4) first time IVF cycles. The delivery/ongoing pregnancy rates were computed. Chi-square statistical comparisons were made.ResultsTabled 1* P<0.01, ** P<0.001ConclusionHigh-responding gonadotropin IUI cycles should be converted to IVF. The increased pregnancy rate in this converted group as compared to first time IVF patients also suggests possible effects of patient selection, down-regulation or FSH acclimatization. The favorable pregnancy rates in the converted cycles also prompts re-evaluation of required FSH/IUI treatment prior to IVF approval in insurance mandated states. ObjectivePublished studies in 1991 reported gonadotropin IUI and IVF live birth rates to be similar. Insurance companies in mandated states have used these prior studies to design criteria for IVF approval; today this often requires the patient complete at least three FSH/IUI cycles before IVF approval. Calculations of IUI versus IVF outcome and cost-effectiveness must incorporate timely pregnancy rates. SART reported an IVF pregnancy rate/retrieval of 15.2% in 1991 vs. 32.6% in 2002. This doubling of IVF pregnancy rates prompts re-evaluation of prior comparisons. This study reviews pregnancy rates in high-responding gonadotropin IUI cycles emergently converted to IVF. These converted cycles provide an initial comparison for fast track versus systematic treatment of patients, where cost and pregnancy outcome are to be considered. Published studies in 1991 reported gonadotropin IUI and IVF live birth rates to be similar. Insurance companies in mandated states have used these prior studies to design criteria for IVF approval; today this often requires the patient complete at least three FSH/IUI cycles before IVF approval. Calculations of IUI versus IVF outcome and cost-effectiveness must incorporate timely pregnancy rates. SART reported an IVF pregnancy rate/retrieval of 15.2% in 1991 vs. 32.6% in 2002. This doubling of IVF pregnancy rates prompts re-evaluation of prior comparisons. This study reviews pregnancy rates in high-responding gonadotropin IUI cycles emergently converted to IVF. These converted cycles provide an initial comparison for fast track versus systematic treatment of patients, where cost and pregnancy outcome are to be considered. DesignA retrospective analysis of IVF and FSH/IUI data in 2004 in a private clinic in an insurance mandated state. A retrospective analysis of IVF and FSH/IUI data in 2004 in a private clinic in an insurance mandated state. Materials and methodsFour patient groups (divided into > and < 38 y.o.) were analyzed for delivery rates: 1) first time IUI cycles 2) total (1-3) IUI cycles; 3) IUI cycles emergently converted to IVF due to ≥ 5 mature follicles present after stimulation; and 4) first time IVF cycles. The delivery/ongoing pregnancy rates were computed. Chi-square statistical comparisons were made. Four patient groups (divided into > and < 38 y.o.) were analyzed for delivery rates: 1) first time IUI cycles 2) total (1-3) IUI cycles; 3) IUI cycles emergently converted to IVF due to ≥ 5 mature follicles present after stimulation; and 4) first time IVF cycles. The delivery/ongoing pregnancy rates were computed. Chi-square statistical comparisons were made. ResultsTabled 1* P<0.01, ** P<0.001 * P<0.01, ** P<0.001 ConclusionHigh-responding gonadotropin IUI cycles should be converted to IVF. The increased pregnancy rate in this converted group as compared to first time IVF patients also suggests possible effects of patient selection, down-regulation or FSH acclimatization. The favorable pregnancy rates in the converted cycles also prompts re-evaluation of required FSH/IUI treatment prior to IVF approval in insurance mandated states. High-responding gonadotropin IUI cycles should be converted to IVF. The increased pregnancy rate in this converted group as compared to first time IVF patients also suggests possible effects of patient selection, down-regulation or FSH acclimatization. The favorable pregnancy rates in the converted cycles also prompts re-evaluation of required FSH/IUI treatment prior to IVF approval in insurance mandated states." @default.
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• W2080136715 date "2005-09-01" @default.
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• W2080136715 title "Should High-Responding Gonadotropin IUI Cycles be Converted to IVF in an Insurance Mandated State?" @default.
• W2080136715 doi "https://doi.org/10.1016/j.fertnstert.2005.07.811" @default.
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