Influence of women's age on the pregnancy outcome of intrauterine insemination with husband's sperm in ovulation-promoting cycle

Objective To investigate the effect of women's age on the pregnancy outcomes of intrauterine in-semination with husband's sperm in ovulation-promoting cycle. Methods The clinical data of 4228 ovulation-promot-ing cycles of intrauterine insemination with the husband's sperm which performed in the Reproductive Center of the First Affiliated Hospital of Hainan Medical University from January 2008 to December 2015 were collected and retrospective-ly analyzed. The correlations between clinical pregnancy rate, delivery rate, miscarriage rate and women's age were ana-lyzed. Results The overall clinical pregnancy rate, delivery rate and miscarriage rate were 14.5％(614/4228), 10.1％(429/4228), and 15.5％(95/614), respectively. According to the women's age, the cycles were divided into the follow-ing groups:21-25 years group, 26-30 years group, 31-35 years group, 36-38 years group, 39-40 years group, over 40 years group. The clinical pregnancy rates of the different age groups were 16.5％(40/242), 16.8％(262/1559), 14.2％(224/1578), 13.1％ (59/451), 8.9％ (18/203) and 5.6％ (11/195), respectively; the delivery rates were 10.3％ (25/242), 12.2％(190/1559), 10.2％(161/1578), 8.4％(38/451), 4.9％(10/203) and 2.6％(5/195), respectively;the abortion rates were 7.5％ (3/40), 14.1％ (37/262), 13.4％ (30/224), 25.4％ (15/59), 27.8％ (5/18), 45.5％ (5/11), respectively. There were statistically significant differences in the clinical pregnancy rate, delivery rate and miscarriage rate between the dif-ferent age groups (P 0.05). The average progressive sperms' count (millions) of the different age groups were (11.7 ± 12.3) millions, (10.4 ± 10.8) millions, (9.9 ± 9.4) millions, (10.2 ± 10.6) millions, (8.9±10.0) millions respectively, and there was no statistical difference between the groups (P>0.05);the duration of infertility respectively were (3.5 ± 1.5) year, (4.3 ± 2.1) year, (5.2 ± 2.7) year, (6.3 ± 3.8) year, (6.3 ± 4.6) year, (6.2±5.2) year;the times of IUI were respectively (1.4±0.6) times, (1.5±0.8) times, (1.6±0.8) times, (1.6±0.8) times, (1.6± 0.9) times, (1.7±1.2) times;the follicles over 14 mm were respectively (2.8±2.1), (2.7±2.1), (2.5±1.9), (2.5±1.8), (2.4±1.6), (2.3±1.4). There were significant differences in the duration of infertility, the times of IUI, the number of the folli-cles with diameter equal or greater than 14 mm between the different age groups (P<0.01). Conclusion Woman's age is the most important factor that affect the IUI pregnancy outcome. In women over 40 years old, IUI might not be the fi rst-line treatment, and the times of IUI treatment might be need to reduce.