Spontaneous pregnancy after successful ICSI treatment: evaluation of risk factors in 899 families in Germany

Abstract

There are only scarce data on the incidence of spontaneous pregnancy in infertility patients. Contraception after infertility treatment is another topic that has been neglected so far. Therefore, a questionnaire was sent to 1614 couples with a child conceived by intracytoplasmic sperm injection (ICSI) aged 4-6 years. A total of 899 couples responded (response rate 55.7%). A total of 10.9% of couples had used contraception. Of the couples that had actively tried to conceive, 20.0% had conceived spontaneously, resulting in a live-birth rate of 16.4%. 74.5% of these pregnancies were conceived within 2 years after delivery. A further 26.6% of couples conceived again by ICSI, with a live-birth rate of 20.9%. Maternal age was the only prognostic factor for spontaneous conception. Parents of multiples after ICSI did not have a higher chance of spontaneous conception than parents of singletons. Couples can be counselled that one out of five couples conceive spontaneously after successful ICSI. Even when assuming that none of the families that were lost to follow-up had conceived spontaneously, one out of eight couples would have conceived spontaneously. Therefore, it is important to counsel patients about the possibility of natural conception and necessity to use contraception despite their history of subfertility.

Spontaneous conceptions within two years of having a first infant with assisted conception

“…It is estimated that 9% of couples at any given time experience infertility, and of these, approximately 55% seek medical care . Follow‐up studies show that about one in five women who give birth after ART subsequently conceive spontaneously . Maternal age has been identified as the most important clinical variable associated with spontaneous conception after successful ART .…”

Spontaneous pregnancies among couples previously treated by in vitro fertilization

“…T he issue of live births following spontaneous pregnancy (BSP) among infertile couples who have had in vitro fertilization (IVF) treatment may seem an unusual one in such a context (1) and may appear to be anecdotal to physicians, especially if treatment has failed (2). However, in view of some recent publications, BSP after IVF may not be such a rare occurrence.…”

“…Because those studies focused only on reasons for treatment dropout, BSP that occurred at a later date were not taken into account. Some studies have evaluated occurrence of BSP specifically among couples who previously had a child through IVF and intracytoplasmic sperm injection (ICSI) (1,2,6). Reported BSP rates ranged from 16% to 17% with a follow-up of 2-5 years.…”

Who does not participate in a follow-up postal study? a survey of infertile couples treated by in vitro fertilization

“…This proportion of lost to follow-up is similar to that observed in other studies of couples after IVF treatment. Among 1,614 eligible German couples, 44% could not be contacted 5 years after the birth of their ICSI child [25]. Among 475 eligible English couples, 25.5% could not be contacted 4 to 10 years after referral to a fertility clinic [26].…”