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Hum. Reprod. Advance Access originally published online on April 20, 2007
Human Reproduction 2007 22(6):1652-1656; doi:10.1093/humrep/dem051
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The length of the fertile window is associated with the chance of spontaneously conceiving an ongoing pregnancy in subfertile couples

M.J. Keulers1,4, C.J.C.M. Hamilton1, A. Franx2, J.L.H. Evers3 and R.S.G.M. Bots2

1 Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, The Netherlands 2 Department of Obstetrics and Gynaecology, St Elisabeth Hospital, Tilburg, The Netherlands 3 Department of Obstetrics and Gynaecology, Research institute GROW, Academic Hospital Maastricht and Maastricht University, The Netherlands

4 Correspondence address. Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, PO Box 90153, 5211 NL ‘s-Hertogenbosch, The Netherlands. Tel: +0031-0652067998; Fax: +0031-0736998650; E-mail: m.keulers{at}haio.umcn.nl

BACKGROUND: The period in each menstrual cycle during which sexual intercourse can result in conception is called the ‘fertile window’. Although the fertile window closes on the day of ovulation, little is known about the moment it opens. We defined the first day of normal sperm–mucus interaction as the opening of the fertile window. We hypothesized that length of the fertile window varies between couples and that the number of days the fertile window is ‘open’ is related to the time to spontaneous conception.

METHODS: Serial post-coital tests and sperm–mucus penetration tests were performed to detect the first normal sperm–mucus interaction day. Ovulation was confirmed by serial ultrasound. Using Cox' regression analysis, we determined whether the fertile window length was associated with time to ongoing pregnancy. This association was expressed in fecundability ratios (FR).

RESULTS: The fertile window length was determined in 410 subfertile couples. The fertile window length varied among couples from <1 to >5 days. The FR increased with increasing fertile window length and varied between 0.11 (95% CI: 0.03–0.45) for a fertile window of 1 day, to 2.4 (95% CI: 1.1–5.2) for a fertile window of 5 days or more.

CONCLUSIONS: The longer the fertile window in subfertile couples, the higher is the probability of spontaneously conceiving an ongoing pregnancy.

Key words: fertile window/sperm–mucus interaction/fertility

Submitted on October 1, 2006; resubmitted on January 24, 2007; accepted on January 26, 2007.


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