The likelihood of achieving pregnancy through timed coitus in young infertile women with decreased ovarian reserve.
10.5653/cerm.2018.45.1.31
- Author:
Hwa Seon KOO
1
;
In Ok SONG
;
Sun Hwa CHA
;
Chan Woo PARK
;
Hye Ok KIM
Author Information
1. Division of Infertility, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
- Publication Type:Original Article
- Keywords:
Anti-Mullerian hormone;
Coitus;
Infertility;
Live birth;
Maternal age;
Ovarian reserve;
Pregnancy;
Unexplained
- MeSH:
Anti-Mullerian Hormone;
Coitus*;
Female;
Humans;
Infertility;
Live Birth;
Maternal Age;
Ovarian Reserve*;
Pregnancy Rate;
Pregnancy*;
Reference Values;
Retrospective Studies;
Superovulation;
Time-to-Pregnancy
- From:Clinical and Experimental Reproductive Medicine
2018;45(1):31-37
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the pregnancy rate and time to pregnancy after timed coitus with or without superovulation in infertile young women younger than 35 years old with low serum anti-Müllerian hormone (AMH) levels (< 25th percentile). METHODS: A total of 202 patients younger than 35 years old were recruited retrospectively between 2010 and 2012. Ninety-eight women had normal serum AMH levels (25–75th percentile), 75 women had low serum AMH levels (5th≤&< 25th percentile) and 29 women had very low serum AMH levels (< 5th percentile), according to reference values for their age group. RESULTS: The clinical pregnancy rate was positively associated with AMH levels, but this trend did not reach statistical significance (43.9% vs. 41.3% vs. 27.6% in the normal, low, and very low AMH groups, respectively). The time to pregnancy was longer in the very low AMH group than in the normal AMH group (13.1±10.9 months vs. 6.9±6.1 months, p=0.030). The cumulative live birth rate over 18 months was lower in the very low AMH group than in the normal AMH group, with marginal significance (20.0% vs. 55.9%, p=0.051). The duration of infertility was negatively correlated with achieving pregnancy (odds ratio, 0.953; 95% confidence interval, 0.914–0.994; p=0.026). CONCLUSION: Conservative management, such as timed coitus with or without superovulation, should be considered in young patients who have low ovarian reserve without any infertility factors. However, for women with a long duration of infertility or very low serum AMH levels, active infertility treatment should be considered.
