Omitting FSH-stimulated cycles brings baby faster and cheaper

Skipping over the gonadotropin-stimulated artificial insemination cycles that usually precede in vitro fertilization (IVF) attempts results in a shorter time to pregnancy and less expense, as well as a lower risk for multiple births, according to the results of a recent randomized clinical trial.

The FASTT (the Fast Track and Standard Treatment Trial) included just over 500 couples with unexplained infertility. Approximately one half of the couples were treated conventionally with three cycles of clomiphene citrate (CC)/IUI, three cycles of gonadotropin/intrauterine stimulation (FSH/IUI), and up to six cycles of IVF, while the other half followed an accelerated protocol that omitted the three cycles of FSH/IUI.

Pregnancy was achieved about 25% faster in the accelerated group. Those couples became pregnant in an average of 8 months, compared with 11 months for the couples in the conventional arm of the study. And, on average, couples in the accelerated arm accumulated almost $10,000 less in total pregnancy and delivery charges than those in the conventional arm, partly because of the direct savings associated with foregoing the FSH/IUI, but also by greatly reducing the increased charges associated with multiple pregnancies and births.