Trends in the use of ICSI: indications and pregnancy outcomes, united states 1996-2011

OBJECTIVE: To examine and compare cycle outcomes among patients demonstrating poor response to ovarian hyperstimulation that proceeded to oocyte retrieval to those that converted to intrauterine insemination (IUI). DESIGN: Cohort Study. MATERIALS AND METHODS: Comparison Groups Women demonstrating poor ovarian response while undergoing planned assisted reproductive technology (ART) cycles who proceeded to oocyte retrieval and In Vitro Fertilization (IVF) Women demonstrating poor ovarian response while undergoing planned ART cycles who converted to IUI. Inclusion Criteria -Cycle data from Greenville Health System REI Office, January 2004 October 2013 -Patients received gonadotropins as part of an ART cycle -Five or fewer follicles measuring greater than or equal to 15 mm in average diameter -Peak estradiol (E2) level less than 1000 pg/dL at time of human chorionic gonadotropin (hCG) trigger -Patients converted to IUI must have had at least one patent fallopian tube and were inseminated with a post-wash total motile sperm count >5 million/mL -Underwent standard stimulation protocols Exclusion Criteria -Sperm counts 39 -Bilateral tubal blockage for IUI group Primary Outcome: Live birth Secondary Outcome: Clinical pregnancy Demographics and Patient Information -Baseline FSH, Anti-M€ullerian hormone, TSH, prolactin, DHEA-S -E2 levels at time of hCG trigger -Height & weight -Ethnicity -Age -Gravidity/Parity -Prior treatment.