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Predictive Factors of Conception and the Cumulative Pregnancy Rate in Subfertile Couples Undergoing Timed Intercourse With Ultrasound

 So Hyun Ahn  ;  Inha Lee  ;  SiHyun Cho  ;  Hye In Kim  ;  Hye Won Baek  ;  Jae Hoon Lee  ;  Yun Jeong Park  ;  Heeyon Kim  ;  Bo Hyon Yun  ;  Seok Kyo Seo  ;  Joo Hyun Park  ;  Young Sik Choi  ;  Byung Seok Lee 
 FRONTIERS IN ENDOCRINOLOGY, Vol.12 : 650883, 2021-04 
Journal Title
Issue Date
cumulative pregnancy rate ; predictive factor ; subfertile couples ; timed intercourse ; ultrasonography
The aim of this study was to determine predictive factors for pregnancy and assess the cumulative pregnancy rate (CPR) and live birth rate (CLBR) in subfertile couples undergoing timed intercourse (TI) using ultrasound. This retrospective cohort study included 285 women (854 cycles) who started TI with ultrasound between January 2017 and October 2019. The overall clinical pregnancy rate was 28.1% (80/285) per couple and 9.4% (80/854) per cycle. Pregnant women had a higher body mass index (BMI), higher percentage of irregular menstrual cycles, a shorter duration of subfertility, lower serum follicle-stimulating hormone levels, and higher anti-Müllerian hormone levels than non-pregnant women. A longer duration of subfertility (≥24 months vs. <12 months; odds ratio: 0.193; 95% confidence interval: 0.043-0.859) and endometriosis (vs. ovulatory factors; odds ratio: 0.282; 95% confidence interval: 0.106-0.746) as causes of subfertility were unfavorable factors that independently affected clinical pregnancy. In subgroup analysis, old age ≥ 35 years [vs. < 35 years; odds ratio: 0.279; 95% confidence interval: 0.083-0.938), a longer duration of infertility ≥24 months (vs. <24 months; odds ratio: 0.182; 95% confidence interval: 0.036-0.913) and a higher BMI ≥ 25 kg/m2(vs. >25 kg/m2; odds ratio: 3.202; 95% confidence interval: 1.020-10.046) in couples with ovulatory factor and a longer duration of infertility ≥24 months (vs. <24 months; odds ratio: 0.185; 95% confidence interval: 0.042-0.819) in couples with non-ovulatory factors were significant independent predictive factors for pregnancy. No significant differences were found in the cycle characteristics between pregnant and non-pregnant women. The CPR substantially increased during the first three cycles and significantly increased until the sixth cycle. No significant increase was observed in the CPR after the sixth cycle. The CLBRs substantially increased during the first three cycles and significantly increased until the fourth cycle. No significant increase was observed in the CLBRs after the fifth cycle. When comparing CPRs and CLBRs according to subfertile causes, CRPs was significantly different and CLBRs was different with borderline significance. Our findings may indicate that women with a longer duration of subfertility or subfertility due to endometriosis have poor outcomes during TI with ultrasound. Women who failed to achieve conception by the fourth or fifth cycle of TI with ultrasound may be encouraged to consider advancing to the next treatment strategy.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hye In(김혜인) ORCID logo https://orcid.org/0000-0001-7961-5988
Kim, Heeyon(김희연)
Park, Yun Jeong(박윤정)
Park, Joo Hyun(박주현)
Baek, Hye Won(백혜원)
Seo, Seok Kyo(서석교) ORCID logo https://orcid.org/0000-0003-3404-0484
Ahn, So Hyun(안소현)
Yun, Bo Hyon(윤보현) ORCID logo https://orcid.org/0000-0001-5703-797X
Lee, Byung Seok(이병석) ORCID logo https://orcid.org/0000-0001-6001-2079
Lee, Inha(이인하) ORCID logo https://orcid.org/0000-0003-4869-6281
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0003-4223-1395
Cho, Si Hyun(조시현) ORCID logo https://orcid.org/0000-0003-2718-6645
Choi, Young Sik(최영식) ORCID logo https://orcid.org/0000-0002-1157-4822
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