Effectiveness of video-based teaching in the use of injectable fertility medications: a randomized controlled pilot study

Abstract

OBJECTIVE: The FORT-T trial (1, 2) has demonstrated that moving quickly to IVF in women over forty leads to shorter time to pregnancy. Similar results were found on the FAST-T trial for younger women (3). However, for a variety of reasons (financial, geographic or personal) not all women have access to IVF. We sought to determine if persistence with Ovulation Induction and Intrauterine Insemination (OI/IUI) beyond three cycles was other than an exercise in futility in women diagnosedwith or without male factor infertility. DESIGN: A retrospective cohort study of 3203 patients who underwent 7,641 OI/IUI cycles from 2001 to 2008. MATERIALS ANDMETHODS: Women undergoing IUI/OI were grouped by age category (20-37 and 38-42) and by ovulation induction cycle group (1-3 and 4-6). The primary outcomewas clinical pregnancy rate (CPR) which required the presence of a gestational sac on sonogram. For statistical analysis we used Chi-square, Fisher’s Exact test and Life-Table Analysis. A Pvalue<0.05 was considered statistically significant. RESULTS: For women without male factor infertility the cumulative CPR was, as expected, higher in young vs. older women (p<0.0001) but not significantly different between cycle groups (1-3 vs. 4-6), regardless of age. For women with male-factor only infertility, older women had a significantly lower cumulative CPR in the first three OI/IUI cycles. However, in cycles 4-6, the older women attain equal success as the younger ones.