Human Reproduction, Vol. 10, No. 7, pp. 1706-1710, 1995
© 1995 European Society of Human Reproduction and Embryology
research-article |
Infertility: Life table analysis of pregnancy rates in a general infertility population relative to ovarian reserve and patient age*
1Department of Obstetrics and Gynaecology, Wilford Hall Medical Center Lackland AFB, TX 2Genetics and IVF Institute Fairfax, VA 3Department of Obstetrics and Gynaecology, University of Florida—Jacksonville Medical Center Jacksonville, FL 4Department of Obstetrics and Gynaecology, New York Medical College Valhalla, NY, USA
Correspondence: 6whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
This study evaluated the impact of age and ovarian reserve status on cumulative pregnancy rates. Approximately 1200 women from a general infertile population underwent ovarian reserve screening with the clomiphene citrate challenge test in the first few months of their initial evaluation. All patients then underwent a thorough infertility evaluation with therapy appropriate for their specific diagnoses. Patients with evidence of tubal disease, peritoneal adhesive disease, or male factor were eliminated. The 588 remaining patients were evaluated based on their age and ovarian reserve status, and their long-term pregnancy rates were compared using life table analyses. There was a dramatic decrease in pregnancy rates associated with an abnormal clomiphene citrate challenge test which was uniformly poor independent of age. Patients with normal ovarian reserve had much higher pregnancy rates, but a significant age-related decline in pregnancy rates was clearly identified. We conclude that women with evidence of diminished ovarian reserve have uniformly poor pregnancy rates independent of their age, but that age remains an important prognostic factor among those with a normal ovarian reserve. The combined use of maternal age and ovarian reserve screening should be used when counselling individual patients regarding their long-term prognoses for conception.
Key words: clomiphene citrate/maternal age/ovarian reserve/ovary/pregnancy rates
5Present address: Department of Obstetrics and Gynaecology, Wayne State University, Detroit, MI, USA
*The views expressed in this article are those of the authors and do not reflect the official policy of the Department of Defense or other Departments of the US Government.
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