A Faster, Less-Expensive, Safer Route to Pregnancy

There is exciting and hopeful news for patients with unexplained infertility. A recent study demonstrates that in bypassing IUI with injectable medications and going straight to IVF, patients will get pregnant at a faster rate, save money, and lessen the chance of having multiple births.

The FASTT (fast-track and standard treatment) Trial, led by Richard Reindollar, M.D., Chair of the Department of Obstetrics and Gynecology at Dartmouth-Hitchcock Medical Center and Dartmouth Medical School, studied 503 couples who met the following criteria. They had no prior fertility treatment, met the definition of infertility (one year of unprotected intercourse) and had no identified causes for their infertility (meaning they had unexplained infertility).

The Trial studied two treatment protocols. In the conventional protocol, patients did three cycles of clomid with IUI, followed by IUI with injectable medications, and then IVF. The accelerated protocol skipped the IUI with injectables, and went straight to IVF following the three Clomid cycles.

The results? Couples in the accelerated arm of the study got pregnant at a faster rate. Of the 503 couples, 64% delivered at least one baby and 10% had a pregnancy beyond five months. Couples in the accelerated arm of the study got pregnant in an average of eight months, while those in the conventional arm got pregnant in an average of eleven months.

“There doesn’t appear to be a role for injectable medications in IUI. It’s faster without it, saves costs, and eliminates the risk of high-order multiples,” according to Reindollar. Additionally, “The study shows that infertility treatments are really successful. If patients can afford treatment, the vast majority of patients will take home a baby today,” he adds.

Alan Penzias, M.D., Surgical Director at Boston IVF, says this is the “best randomized trial” in the last 10 years, and he is “gratified to see the evolution of data-driven case management and patient management.” He adds, “Real data helps us understand and correct the algorithm for patients with infertility.”

Couples seeking treatment at Boston IVF or Harvard Vanguard Medical Associates were screened for eligibility to participate in the study. The fact that the study took place in Massachusetts is important, as Massachusetts is only one of 15 states that mandates insurance coverage for infertility treatment. Without the mandate, such a large-scale study would not be possible.

Both Reindollar and Penzias say that physicians are changing the way they approach treatment as a result of the findings. In addition, some insurers that have required IUI prior to IVF treatment are revising those requirements, and it’s anticipated that more will follow suit.

To view the abstract of the study, follow this link.