The results of natural fertility related to women for 35 years
What is the level of natural conception that leads to ongoing pregnancy or livestbirth more than 6-12 months for infertile women aged ≥35 years?
The level of natural conception is still clinically relevant to women aged 35 years and above and significantly higher in women with infertility that cannot be explained compared to other diagnoses.
In recent years, the increasing number of women has tried to get pregnant at the next age, resulting in a commensurate increase in the need for art. However, there is a shortage of data about the results of natural fertility (i.e. no intervention) in women with age.
Systematic review with each participant data (IPD) meta-analysis is carried out. PubMed, Medline, Embase, Cochrane Library, Clinicaltrials.gov are being sought until July 1, 2018 including the search term 'fertility service', 'waiting list', 'care-independent' and 'spontaneous conception' and '. Language restrictions are not forced.
The inclusion criteria are research (at least in part) report on infertile couples with female partners ≥35 years who attend fertility services, undergo fertility work (eg history, semen analysis, tubal status and ovulation status) and exposed to natural conception (eg. Regardless of treatment like IVF, ovulation induction and tubal operations). Studies that exclusively only learn one diagnosis of infertility, without including other women who present infertility services for other causes of infertility, issued. For studies that meet the inclusion criteria, the research writer was contacted to provide the IPD, after which the results of fertility for women aged ≥35 years was taken. It's time for pregnancy or spider and the effect of increasing age on the results of fertility after adjustment for other prognostic factors are analyzed. The quality of the study is assessed by the Newcastle-Ottawa scale (non-randomized controlled trials (RCT)) or the risk of cochrane from the bias tool (for RCTS).
We cover nine studies (seven cohort studies and two RCTs) (n = 4379 women are at least 35 years old), with the primary results of composite observed from ongoing pregnancies or profits that occurred in 429 women (9.8%) on follow-up 5-month median (25th to 75th percentile: 2.5-8 months). Medium quality studies to high. The probability of natural conception decreases significantly with the diagnosis of infertility, when compared to infertility that cannot be explained. We find non-linear effects of women's age and duration of infertility in sustainable pregnancies and predictable probabilities for infertile women who cannot be explained aged 35-42 years with primary or secondary infertility and with the duration of infertility from 1 to 6 years. For 35-year-old women with 2 years of primary infertility that cannot be explained, the probability of natural fertility over age 35 which leads to pregnancy or ongoing profit is 0.15 (95% CI 0.11-0.19) after 6 Moon and 0.24 (95% CI 0.17-0.30) after 12 months. For women aged 42 years, this declined to 0.08 (95% CI 0.04-0.11) after 6 months and 0.13 (95% CI 0.07-0.18) after 12 months.
In the selected study, there are various research designs, recruitment strategies in various centers, protocols and countries and various infertility assessment methods. Data is limited to women over the age of 40 years.
