Pregnancy chances on an IVF/ICSI waiting list: a national prospective cohort study

Eijkemans MJ, M J C Eijkemans, A M E Lintsen, Lintsen AM, C C Hunault, Hunault CC, Bouwmans CA, C A M Bouwmans, L Hakkaart, Hakkaart L, Braat DD, D D M Braat, Habbema JD, J D F Habbema
Human Reproduction · 2008 · doi:10.1093/humrep/den132 · PMID:18456667
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This national prospective cohort study found that treatment-free pregnancy rates on IVF waiting lists are generally low, ranging from 0% to 25%, with endometriosis patients showing lower spontaneous conception odds compared to those with tubal infertility.

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This prospective cohort study analyzed treatment-free pregnancy rates among 5962 couples registered on a national IVF waiting list in the Netherlands. The research utilized Cox regression to assess how female age, infertility duration, and diagnostic categories influenced spontaneous conception during the waiting period. Results indicated that while the overall cumulative probability of ongoing pregnancy was only 9% at twelve months, specific groups such as those with unexplained infertility had significantly higher predicted chances compared to those with tubal issues. Relevance to endometriosis: listed as one diagnostic category for infertility, though the paper's main focus is estimating natural pregnancy rates on an IVF waitlist rather than treating adenomyosis or endometriosis directly.

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Abstract

BACKGROUND: The effectiveness of IVF over expectant management has been proven only for bilateral tubal occlusion. We aimed to estimate the chance of pregnancy without treatment for IVF patients, using data on the waiting period before the start of IVF. METHODS: A prospective cohort study included all couples eligible for IVF or ICSI treatment, registered in a national waiting list in The Netherlands. The cumulative probability of treatment-free ongoing pregnancy on the IVF waiting list was assessed and the predictive effect of female age, duration of infertility, primary or secondary infertility and diagnostic category was estimated using Cox regression. RESULTS: We included 5962 couples on the waiting list. The cumulative probability of treatment-free ongoing pregnancy was 9% at 12 months. In multivariable Cox regression, hazard ratios were: 0.95 (P < 0.001) per year of the woman's age, 0.85 (P < 0.001) per year of duration of infertility, 0.71 (P = 0.005) for primary versus secondary infertility. Diagnostic category showed hazard ratios of 0.7, 1.6, 1.2, 1.7 and 2.6 for endometriosis, male factor, hormonal, immunological and unexplained infertility, respectively, compared with 'tubal infertility' (P < 0.001). The 12-months predicted probabilities ranged from 0% to 25%. CONCLUSIONS: The chance of an ongoing pregnancy without treatment while waiting for an IVF or ICSI is below 10% but may be as high as 25% within 1 year for selected patient groups. Timing of IVF should take predictive factors into consideration.
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Abstract BACKGROUND: The effectiveness of IVF over expectant management has been proven only for bilateral tubal occlusion. We aimed to estimate the chance of pregnancy without treatment for IVF patients, using data on the waiting period before the start of IVF. METHODS: A prospective cohort study included all couples eligible for IVF or ICSI treatment, registered in a national waiting list in The Netherlands. The cumulative probability of treatment-free ongoing pregnancy on the IVF waiting list was assessed and the predictive effect of female age, duration of infertility, primary or secondary infertility and diagnostic category was estimated using Cox regression. RESULTS: We included 5962 couples on the waiting list. The cumulative probability of treatment-free ongoing pregnancy was 9% at 12 months. In multivariable Cox regression, hazard ratios were: 0.95 (P < 0.001) per year of the woman's age, 0.85 (P < 0.001) per year of duration of infertility, 0.71 (P = 0.005) for primary versus secondary infertility. Diagnostic category showed hazard ratios of 0.7, 1.6, 1.2, 1.7 and 2.6 for endometriosis, male factor, hormonal, immunological and unexplained infertility, respectively, compared with 'tubal infertility' (P < 0.001). The 12-months predicted probabilities ranged from 0% to 25%. CONCLUSIONS: The chance of an ongoing pregnancy without treatment while waiting for an IVF or ICSI is below 10% but may be as high as 25% within 1 year for selected patient groups. Timing of IVF should take predictive factors into consideration. | Original language | Undefined/Unknown | |---|---| | Pages (from-to) | 1627-1632 | | Number of pages | 6 | | Journal | Human Reproduction | | Volume | 23 | | Issue number | 7 | | DOIs | | | Publication status | Published - 2008 | Research programs - EMC NIHES-02-65-01 Cite this - APA - Author - BIBTEX - Harvard - Standard - RIS - Vancouver

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Condition tags

endometriosisinfertility

MeSH descriptors

Fertilization in Vitro Pregnancy Rate Sperm Injections, Intracytoplasmic Waiting Lists Adult Female Humans Netherlands Pregnancy Prospective Studies

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