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This study found that 15.6% of infertile women became pregnant spontaneously, with secondary infertility, previous miscarriages, younger age, and recent desire for a child being favorable prerequisites, particularly for specific etiologies like endometriosis or reduced tubal patency.
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This retrospective study analyzed 857 women treated for sterility at the University of Heidelberg to determine the incidence and prerequisites for therapy-independent pregnancies. The researchers found that 15.6% of the cohort conceived spontaneously, with favorable outcomes associated with secondary sterility, prior miscarriages, younger age, and a shorter duration of infertility. Notably, patients with endometriosis exhibited the highest rate of spontaneous pregnancy at 75%, surpassing those with tubal factors or hormonal disturbances. This paper is centrally about endometriosis — specifically noting it as one of several causes of sterility where a high proportion of patients achieve spontaneous pregnancy without active treatment.
Abstract
15.6% of 857 women who had been treated because of sterility in the infertility centre of the Department of Gynaecology of the University of Heidelberg between May 1982 and June 1985, became pregnant up to June 1986, independent of the therapy. Favourable conditions for the occurrence of pregnancy were provided by secondary sterility and miscarriages in the previous history (in case of non-hormonal disturbances only). Younger women and those whose wish for a child was more recent, had a better chance to experience pregnancy--without any difference between the spontaneously pregnant women and those who became pregnant during treatment. ("Spontaneous pregnancy" signified women who became pregnant either during diagnostic procedure or after having discontinued medical treatment for more than 3 months, in case of tubal microsurgery 12 months). Depending upon the aetiology of surgery, the proportion of spontaneous pregnancies was between 12 and 75%. The rate of spontaneous pregnancies was highest in case of reduced tubal patency (44%), disturbances of hormonal control mechanisms (62.5%) and endometriosis (75%). The spontaneous pregnancy rate was comparable to the overall pregnancy rate (39.4%) in women with uterine malformations (31.4%), immunologic infertility (33.3%), hyperandrogenemia (33.3), hyperprolactinaemia (31.2%) and PCO syndrome (37.5%). The percentage of spontaneous pregnancies was lowest in hypothyroidism (20%), primary ovarian insufficiency (12.5%) and disturbances of the hypothalamic-pituitary axis (16.7%).
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DOI: 10.1055/s-2007-1026459
© Georg Thieme Verlag Stuttgart · New York
Häufigkeiten und Voraussetzungen für therapieunabhängige Schwangerschaften bei Sterilitätspatientinnen
Incidence and Conditions for Therapy-Independent Pregnancies in Patients under Treatment for SterilityPublication History
Publication Date:
18 March 2008 (online)
Zusammenfassung
Von 857 Frauen, die zwischen Mai 1982 und Juni 1985 in der Hormonsprechstunde der Universitätsfrauenklinik Heidelberg wegen Sterilität behandelt worden waren, wurden 15,6 % bis Juni 1986 therapieunabhängig schwanger. Günstige Voraussetzungen für das Auftreten einer spontanen Schwangerschaft waren eine sekundäre Sterilität und Aborte in der Vorgeschichte (nur bei nichthormonellen Störungen). Jüngere Frauen und solche mit kürzerer Kinderwunschdauer hatten bessere Aussichten auf eine Schwangerschaft, wobei sich die Spontanschwangeren nicht von den Therapieschwangeren unterschieden.
Bei der Betrachtung der einzelnen Sterilitätsursachen lag der Anteil der Spontanschwangeren an allen Schwangeren je nach Störung zwischen 12 und 75 %. Pathologischer Tubenfaktor (44,0 %), Störungen der hormonellen Kontrollmechanismen (62,5 %) und Endometriose (75 %) hatten den höchsten Anteil spontaner Schwangerschaften. Bei pathologischem Uterusfaktor (31,4 %), immunologischen Sterilitätsursachen (33,3 %), Hyperandrogenämie (33,3 %), Hyperprolaktinämie (31,2 %) und PCO-Syndrom (37,5 %) entsprach der Anteil der Patientinnen, die spontan konzipierten, etwa dem Durchschnitt im Gesamtkollektiv (39,4 %). Bei Hypothyreose (20 %), primär ovariellen Störungen (12,5 %) und Störungen der hypothalamisch-hypophysären Achse (16,7%) traten die wenigsten spontanen Schwangerschaften auf.
Abstract
15.6% of 857 women who had been treated because of sterility in the infertility centre of the Department of Gynaecology of the University of Heidelberg between May 1982 and June 1985, became pregnant up to June 1986, independent of the therapy. Favourable conditions for the occurrence of pregnancy were provided by secondary sterility and miscarriages in the previous history (in case of non-hormonal disturbances only). Younger women and those whose wish for a child was more recent, had a better chance to experience pregnancy - without any difference between the spontaneously pregnant women and those who became pregnant during treatment. („Spontaneous pregnancy“ signified women who became pregnant either during diagnostic procedure or after having discontinued medical treatment for more than 3 months, in case of tubal microsurgery 12 months).
Depending upon the aetiology of surgery, the proportion of spontaneous pregnancies was between 12 and 75 %. The rate of spontaneous pregnancies was highest in case of reduced tubal patency (44 %), disturbances of hormonal control mechanisms (62.5 %) and endometriosis (75 %). The spontaneous pregnancy rate was comparable to the overall pregnancy rate (39.4 %) in women with uterine malformations (31.4%), immunologic infertility (33.3%), hyperandrogenaemia (33.3), hyperprolactinaemia (31.2 %) and PCO syndrome (37.5 %). The percentage of spontaneous pregnancies was lowest in hypothyroidism (20 %), primary ovarian insufficiency (12.5 %) and disturbances of the hypothalamic- pituitary axis (16.7 %).
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