Predictive value of pregnancy history in subfertile couples: results from a nationwide cohort study in the Netherlands.
OBJECTIVE
To assess whether pregnancy history can predict the occurrence of a spontaneous ongoing pregnancy in subfertile couples.


METHODS
Prospective cohort study.


METHODS
Thirty fertility centers in the Netherlands.


METHODS
Subfertile, ovulatory women with at least one patent tube and male partners without severely impaired semen quality.


METHODS
Fertility work-up, including a detailed pregnancy history.


METHODS
Spontaneous ongoing pregnancy.


RESULTS
We included 4445 couples, of whom 793 (18%) had a spontaneous ongoing pregnancy within 1 year of follow-up. Previous live birth and miscarriage in current partnership were both associated with higher fecundity as compared with primary infertility (hazard rate ratios for spontaneous pregnancy [HR] 1.4; 95% CI, 1.2-1.7 and 1.3; 95% CI, 1.0-1.5, respectively). Pregnancies in a woman's previous partnerships did not affect the fecundity of the couple. A pregnancy in a previous partnership of the male partner was associated with lower fecundity (HR 0.76; 95% CI, 0.58-0.99). A previous pregnancy after fertility treatment also was associated with lower fecundity (HR 0.52; 95% CI, 0.30-0.90).


CONCLUSIONS
Accurate prediction of the future fertility of a couple requires an exact assessment of the fertility history of both partners.
van der Steeg
Jan W
JW
Center for Reproductive Medicine, Academic Medical Center, Amsterdam, The Netherlands. j.w.vandersteeg@amc.uva.nl
Steures
Pieternel
P
Eijkemans
Marinus J C
MJ
Habbema
J Dik F
JD
Hompes
Peter G A
PG
Michgelsen
Henri W B
HW
van der Heijden
Pieter F M
PF
Bossuyt
Patrick M M
PM
van der Veen
Fulco
F
Mol
Ben W J
BW
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007246:Infertility / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity