title: Stress relief after infertility treatment--spontaneous conception, adoption and psychological counselling.
abstract: OBJECTIVE
  In this study, we sought to evaluate characteristics of couples with spontaneous conceptions after treatment with assisted reproductive technologies (ART).
  
  
  METHODS
  Data from 254 couples who underwent 1127 therapy cycles between November 1987 and February 1997, were analyzed. Chi-Square (chi(2)) test and Student's t-test were used. P<0.05 was considered significant.
  
  
  RESULTS
  Spontaneous pregnancies occurred in 14% of all treated couples. Psychological counselling only was performed in 21% but was observed significantly more frequently among patients without later spontaneous conception. Ten percent of all treated couples applied for adoption. The miscarriage rate was significantly higher in the group of treatment dependent pregnancies compared to the group of patients with later spontaneous conception (27% versus 9%). The spontaneous conception rate differed significantly depending on women's age and normal semen analysis.
  
  
  CONCLUSIONS
  Appearance of spontaneous conception after ART-procedures should be taken into account in the first patient's interview. Depending on women's age and andrological parameters, treatment-success will differ. The positive impact of psychological counselling for stress relief during and after therapy should also be noted, even though a statistically significant impact could not be demonstrated in the present study. Adoption should be discussed as an alternative to overcome infertility.
authors.affiliation: Fertility Workgroup--Reproduction Medicine & Endocrinology, Munich University Hospital--City Centre, Ludwig-Maximilian-University, Maistrasse 11, D-80337, Muenchen, Germany. mail@kupka.info
authors.forename: Markus S
authors.initials: MS
authors.lastname: Kupka
authors.forename: Christoph
authors.initials: C
authors.lastname: Dorn
authors.forename: Oliver
authors.initials: O
authors.lastname: Richter
authors.forename: Andreas
authors.initials: A
authors.lastname: Schmutzler
authors.forename: Hans
authors.initials: H
authors.lastname: van der Ven
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kulczycki
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000300:Adoption; D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage; D003376:Counseling; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007315:Insemination, Artificial; D008297:Male; D008596:Menotropins / Q000627:therapeutic use; D008875:Middle Aged; D010062:Ovulation Induction; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000523:psychology*; D020554:Sperm Injections, Intracytoplasmic; D013315:Stress, Psychological / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D002996:Clomiphene; D008596:Menotropins