Hum. Reprod. Advance Access published online on June 10, 2008
Human Reproduction, doi:10.1093/humrep/den136
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Fecundability and spontaneous abortions in women with self-reported oligo-amenorrhea and/or hirsutism: Northern Finland Birth Cohort 1966 Study
1 Family Federation of Finland, 90220 Oulu, Finland 2 Department of Obstetrics and Gynaecology, University Hospital of Oulu, Kajaanintie 52, 90029 Oulu, Finland 3 National Public Health Institute, 90220 Oulu, Finland 4 Institute of Reproductive and Developmental Biology, Imperial College London, London, UK 5 Department of Epidemiology and Public Health, Imperial College London, London, UK 6 Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, UK 7 Department of Clinical Chemistry, University Hospital of Oulu, 90029 Oulu, Finland 8 Department of Public Health Science and General Practice, University of Oulu, 90220 Oulu, Finland
9 Correspondence address. Tel: +358-8-3154109; Fax: +358-8 3154310; E-mail: lmp{at}cc.oulu.fi
BACKGROUND: Women with polycystic ovary syndrome (PCOS) suffer from anovulatory infertility and hospital-based studies suggest that they have an increased risk of spontaneous abortion. Our aim was to investigate the proportion of women, with self-reported oligo-amenorrhea and/or hirsutism in a general population, who had suffered from infertility, the percentage of them managing to conceive and their rate of spontaneous abortion.
METHODS: At age 31, a postal questionnaire including questions about hirsutism and oligo-amenorrhea was sent to all women from the population-based Northern Finland Birth Cohort 1966 (total n = 5889). Of these, 4535 (79.5%) answered the questionnaire, 1103 reported hirsutism and/or oligo/amenorrhea (symptomatic women) and 3420 were non-symptomatic. The fecundability ratio (FR) was defined as the probability of conception of a clinically detectable pregnancy within 12 months.
RESULTS: The overall pregnancy (77.7% versus 75.6%) and spontaneous abortion (19.3% versus 18.6%) rates did not differ between the two groups and the risk of spontaneous abortion was not associated with body mass index (BMI), waist-to-hip ratio (WHR) or waist circumference. Symptomatic women had suffered more often from infertility than non-symptomatic women (19.4% versus 11.1%, P < 0.01). Oligo-amenorrhea and/or hirsutism (FR = 0.74, P < 0.001) and obesity (FR = 0.68, P = 0.002) were both independently associated with decreased fecundability, but symptomatic women had become pregnant and had one or two successful deliveries as often as non-symptomatic women.
CONCLUSIONS: Women with self-reported oligo-amenorrhea and/or hirsutism had lower fecundability and suffered more often from infertility, but had at least one delivery as often as non-symptomatic women, and did not exhibit an increased risk of spontaneous abortion.
Key words: PCOS/spontaneous abortion/infertility/oligo-amenorrhea/hirsutism
Submitted on December 18, 2007; resubmitted on March 18, 2008; accepted on April 1, 2008.
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