Time to pregnancy after a previous miscarriage in subfertile couples
Received 26 January 2009; received in revised form 21 March 2009; accepted 24 March 2009. published online 13 May 2009.
Objective
To assess the time to spontaneous ongoing pregnancy after a previous miscarriage in subfertile couples.
Design
A prospective cohort study.
Setting
The study was conducted in 38 fertility centers in the Netherlands.
Patient(s)
Subfertile couples who miscarried after completing their basic fertility work-up.
Intervention(s)
Expectant management after a miscarriage.
Main Outcome Measure(s)
Spontaneous ongoing pregnancy.
Result(s)
We included 5,663 subfertile couples, of which 1,098 (19%) conceived spontaneously. Among these 1,098 couples, 199 (18%) miscarried and these couples were included in the present study. Follow-up was completed for 171 couples, of which 95 conceived again within 24 months of follow-up. Of these 95 pregnancies, 86 (91%) were ongoing. The cumulative spontaneous ongoing pregnancy rate (PR) after 24 months was 70% (95% confidence interval [CI] 59%–81%).
Conclusion(s)
Subfertile couples, who experience a treatment-independent pregnancy resulting in a miscarriage, have very good prospects of a spontaneous ongoing pregnancy in the near future. This information is useful in counseling couples who had a miscarriage after a previous period of subfertility.
aDepartment of Obstetrics and Gynecology, St. Antonius Hospital, Nieuwegein, The Netherlands
bCentre for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands
cDepartment of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
dCentre for Reproductive Medicine, Vrije Universiteit Medical Hospital, Amsterdam, The Netherlands
eDepartment of Obstetrics and Gynecology, Westfries Gasthuis, Hoorn, The Netherlands
fDepartment of Clinical Epidemiology, Biostatistics and Biometrics, Academic Medical Centre, Amsterdam, The Netherlands
gDepartment of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, the Netherlands
Reprint requests: Tessa Cox-Witbraad, M.D., St. Antonius Hospital Centre, Department of Obstetrics and Gynecology, Koekoekslaan 1, 3430 EM, Nieuwegein, the Netherlands (FAX: 0031-30-6051270).
T.C. has nothing to disclose. J.-W.v.d.S. has nothing to disclose. P.S. has nothing to disclose. P.G.A.H. has nothing to disclose. F.v.d.V. has nothing to disclose. M.J.C.E. has nothing to disclose. J.H.S.v.L. has nothing to disclose. C.R. has nothing to disclose. P.M.M.B. has nothing to disclose. B.W.J.M. has nothing to disclose.
Partly facilitated by grant 945 12 002 from ZonMW, The Netherlands Organization for Health Research and Development, The Hague, The Netherlands.
ABSTRACT