[Therapy of idiopathic sterility].

INTRODUCTION

During the period 1996-2000, we investigated 900 couples with infertility. In 71 (7.9%) couples no cause of sterility was revealed. These patients were divided according to age, parity and infertility duration.

MATERIAL AND METHODS

We established the cumulative conception rate and cycle fecundity after three months without therapy, after three cycles of intrauterine insemination and after three cycles of in vitro fertilization (eventually intracytoplasmic sperm injection). Among patients with less than three years of infertility, cumulative conception rate was 34.8% after three months without therapy, 27.3% after three cycles of intrauterine insemination and 66.7% after three cycles of in vitro fertilization.

RESULTS AND DISCUSSION

In patients with infertility longer than three years, cumulative conception rate without therapy was 12.5%, with intrauterine insemination 16.1% and with in vitro fertilization 40.5%. Differences regarding the age of patients were significant. Based on these findings, we proposed an optimal therapy regimen: three months therapy delay is desirable in patients under 30 years of age with infertility duration under three years. If there is no pregnancy in that period, intrauterine insemination is performed in three to four cycles. In case of intrauterine insemination failure in these women, in vitro fertilization and embryo transfer should be applied. In the group of women over 30 years of age, with infertility longer than three years, the possibility for occurrence of pregnancy with intrauterine insemination is slightly increased. If more than 4 follicles develop during preparations for intrauterine insemination, it is advisable to change the course to in vitro fertilization. In women older than 35, with primary or secondary infertility, in vitro fertilization should be performed from the very beginning.