Fecundability and spontaneous abortions in women with self-reported oligo-amenorrhea and/or hirsutism: Northern Finland Birth Cohort 1966 Study.
BACKGROUND
Women with polycystic ovary syndrome (PCOS) suffer from anovulatory infertility and hospital-based studies suggest that they have an increased risk of spontaneous abortion. Our aim was to investigate the proportion of women, with self-reported oligo-amenorrhea and/or hirsutism in a general population, who had suffered from infertility, the percentage of them managing to conceive and their rate of spontaneous abortion.


METHODS
At age 31, a postal questionnaire including questions about hirsutism and oligo-amenorrhea was sent to all women from the population-based Northern Finland Birth Cohort 1966 (total n = 5889). Of these, 4535 (79.5%) answered the questionnaire, 1103 reported hirsutism and/or oligo/amenorrhea (symptomatic women) and 3420 were non-symptomatic. The fecundability ratio (FR) was defined as the probability of conception of a clinically detectable pregnancy within 12 months.


RESULTS
The overall pregnancy (77.7% versus 75.6%) and spontaneous abortion (19.3% versus 18.6%) rates did not differ between the two groups and the risk of spontaneous abortion was not associated with body mass index (BMI), waist-to-hip ratio (WHR) or waist circumference. Symptomatic women had suffered more often from infertility than non-symptomatic women (19.4% versus 11.1%, P < 0.01). Oligo-amenorrhea and/or hirsutism (FR = 0.74, P < 0.001) and obesity (FR = 0.68, P = 0.002) were both independently associated with decreased fecundability, but symptomatic women had become pregnant and had one or two successful deliveries as often as non-symptomatic women.


CONCLUSIONS
Women with self-reported oligo-amenorrhea and/or hirsutism had lower fecundability and suffered more often from infertility, but had at least one delivery as often as non-symptomatic women, and did not exhibit an increased risk of spontaneous abortion.
Family Federation of Finland, 90220 Oulu, Finland.
R
R
Koivunen
A
A
Pouta
S
S
Franks
H
H
Martikainen
U
U
Sovio
A-L
AL
Hartikainen
M I
MI
McCarthy
A
A
Ruokonen
A
A
Bloigu
M-R
MR
Järvelin
L
L
Morin-Papunen
D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005298:Fertility; D005387:Finland; D006628:Hirsutism / Q000150:complications*; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000150:complications* / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D009839:Oligomenorrhea / Q000150:complications*; D011085:Polycystic Ovary Syndrome / Q000150:complications; D011247:Pregnancy; D018873:Pregnancy Rate; D012307:Risk Factors; D049629:Waist-Hip Ratio