Predictive value of pregnancy history in subfertile couples: results from a nationwide cohort study in the Netherlands

Jan W. van der Steeg, Pieternel Steures, Marinus J. C. Eijkemans, J. Dik F. Habbema, Peter G. A. Hompes, Henri W. B. Michgelsen, Pieter F. M. van der Heijden, Patrick M. M. Bossuyt, Fulco van der Veen, Ben W. J. Mol

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Abstract

OBJECTIVE: To assess whether pregnancy history can predict the occurrence of a spontaneous ongoing pregnancy in subfertile couples. DESIGN: Prospective cohort study. SETTING: Thirty fertility centers in the Netherlands. PATIENT(S): Subfertile, ovulatory women with at least one patent tube and male partners without severely impaired semen quality. INTERVENTION(S): Fertility work-up, including a detailed pregnancy history. MAIN OUTCOME MEASURE(S): Spontaneous ongoing pregnancy. RESULT(S): We included 4445 couples, of whom 793 (18%) had a spontaneous ongoing pregnancy within 1 year of follow-up. Previous live birth and miscarriage in current partnership were both associated with higher fecundity as compared with primary infertility (hazard rate ratios for spontaneous pregnancy [HR] 1.4; 95% CI, 1.2-1.7 and 1.3; 95% CI, 1.0-1.5, respectively). Pregnancies in a woman's previous partnerships did not affect the fecundity of the couple. A pregnancy in a previous partnership of the male partner was associated with lower fecundity (HR 0.76; 95% CI, 0.58-0.99). A previous pregnancy after fertility treatment also was associated with lower fecundity (HR 0.52; 95% CI, 0.30-0.90). CONCLUSION(S): Accurate prediction of the future fertility of a couple requires an exact assessment of the fertility history of both partners
Original languageEnglish
Pages (from-to)521-527
JournalFertility and Sterility
Volume90
Issue number3
DOIs
Publication statusPublished - 2008

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