Authors:

Snick HKA. Snick TS. Evers JLH. Collins JA.

Institution:

J.L.H. Evers, Department of Obstetrics Gynaecology, Academisch Ziekenhuis

Maastricht, PO Box 5800, 6202 AZ Maastricht; Netherlands.

Title:

The spontaneous pregnancy prognosis in untreated subfertile couples: The Walcheren primary care study. (1997 2876)

Source:

Human Reproduction. Vol 12(7) (pp582-1588), 1997.

Abstract:

The spontaneous pregnancy prognosis of couples in a primary care situation has never been studied. Prognostic models have been developed for referral populations only. We wished to develop a prognostic model to estimate the likelihood of live birth and the impact of prognostic factors among untreated subfertile couples in a primary care situation. With this aim, we conducted a cohort follow-up study of 726 couples in the peninsula of Walcheren, a geographically isolated, but demographically and socioeconomically representative area of an industrialized Western society. The Netherlands. Of the Walcheren population, 9.9% exhibit subfertility complaints at least once during their lifetime. There were 201 live birth conceptions during 9915 months of untreated observation. The cumulative rate of conceptions leading to live births was 52.5% when all of the untreated observations were considered, and 72.0% in the subgroup of 342 couples who remained untreated throughout their follow-up. The relevant prognostic factors in this primary care subfertility population were: abnormal post-coital test, tubal defect, ovulation defect, and duration of subfertility. A prediction score based on these factors would be accurate in [similar] 76-79% of cases. Live birth prognosis can be estimated with sufficient accuracy to be useful in counselling subfertility patients, and in planning clinical management.



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