Clin Exp Reprod Med.  2018 Mar;45(1):31-37. 10.5653/cerm.2018.45.1.31.

The likelihood of achieving pregnancy through timed coitus in young infertile women with decreased ovarian reserve

• Koo HS
• Song IO
• Cha SH
• Park CW
• Kim HO

• KMID: 2408574
• DOI: http://doi.org/10.5653/cerm.2018.45.1.31

Abstract

OBJECTIVE
To evaluate the pregnancy rate and time to pregnancy after timed coitus with or without superovulation in infertile young women younger than 35 years old with low serum anti-Müllerian hormone (AMH) levels (< 25th percentile).
METHODS
A total of 202 patients younger than 35 years old were recruited retrospectively between 2010 and 2012. Ninety-eight women had normal serum AMH levels (25-75th percentile), 75 women had low serum AMH levels (5th≤&< 25th percentile) and 29 women had very low serum AMH levels (< 5th percentile), according to reference values for their age group.
RESULTS
The clinical pregnancy rate was positively associated with AMH levels, but this trend did not reach statistical significance (43.9% vs. 41.3% vs. 27.6% in the normal, low, and very low AMH groups, respectively). The time to pregnancy was longer in the very low AMH group than in the normal AMH group (13.1±10.9 months vs. 6.9±6.1 months, p=0.030). The cumulative live birth rate over 18 months was lower in the very low AMH group than in the normal AMH group, with marginal significance (20.0% vs. 55.9%, p=0.051). The duration of infertility was negatively correlated with achieving pregnancy (odds ratio, 0.953; 95% confidence interval, 0.914-0.994; p=0.026).
CONCLUSION
Conservative management, such as timed coitus with or without superovulation, should be considered in young patients who have low ovarian reserve without any infertility factors. However, for women with a long duration of infertility or very low serum AMH levels, active infertility treatment should be considered.

Keyword

Anti-Mullerian hormone; Coitus; Infertility; Live birth; Maternal age; Ovarian reserve; Pregnancy; Unexplained

MeSH Terms

Anti-Mullerian Hormone
Coitus*
Female
Humans
Infertility
Live Birth
Maternal Age
Ovarian Reserve*
Pregnancy Rate
Pregnancy*
Reference Values
Retrospective Studies
Superovulation
Time-to-Pregnancy
Anti-Mullerian Hormone