Obstetric outcome in patients with unexplained infertility: comparison of treatment-related and spontaneous pregnancies.
BACKGROUND
The aim of this study was to determine the long-term prognosis of fecundity among couples with unexplained infertility and to compare pregnancy course and outcome in spontaneous versus treatment-related pregnancies.


METHODS
A prospective follow-up study of 70 couples with a diagnosis of unexplained infertility. All couples had participated in a study at the Helsinki University Central Hospital where the effectiveness was compared with intrauterine insemination, direct intraperitoneal insemination or timed intercourse, each combined with superovulation. The follow-up was carried out by collecting all available information on treatment-related and spontaneous pregnancies from hospital records and questionnaires mailed to these same women 6 years later.


RESULTS
Of 70 couples, 45 (64.3%), conceived during the follow-up period. Of all 83 pregnancies, 50 (60.2%) began spontaneously and 33 (39.8%) with infertility treatment. Rate of multiple deliveries was 25% in treatment-related pregnancies, but only 2.8% in spontaneous pregnancies (p<0.05). Mean birthweight among singleton pregnancies was 3 120 grams in treatment-related, and 3387 grams in spontaneous pregnancies (p<0.05). The rate of small-for-gestational-age (<-2 s.d.) and preterm births (before 37 completed weeks) in both groups was equal.


CONCLUSIONS
The long-term prognosis of couples with unexplained infertility was good, and many of the pregnancies began spontaneously. The birthweight of singleton neonates in treatment-related pregnancies was lower than in spontaneously conceived pregnancies, but otherwise perinatal outcome was similar.
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.
R
R
Isaksson
A
A
Tiitinen
D005260:Female; D005544:Forecasting; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007248:Infertility, Male / Q000628:therapy*; D007315:Insemination, Artificial / Q000379:methods; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D013480:Superovulation