| Fertility treatments and outcomes among couples seeking fertility care: data from a prospective fertility cohort in the United States. | |
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MedLine Citation:
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PMID: 20659733 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the relationship between number of fertility treatment cycles and pregnancy rates. DESIGN: Prospective cohort study. SETTING: Eight community and academic infertility practices. PATIENT(S): Four hundred eight (408) couples presenting for an infertility evaluation. INTERVENTION(S): Face-to-face and telephone interviews and questionnaires. MAIN OUTCOME MEASURE(S): Incidence of pregnancy. Cox regression analysis compared the efficacy of cycle-based fertility treatments with no cycle-based fertility treatment after multivariable adjustment. RESULT(S): Couples using one to two medications-only cycles had a significantly higher pregnancy rate (hazard ratio [HR] 4.7 [95% confidence interval 1.3-16.6]), a benefit that did not persist after three or more cycles (HR 0.6 [0.1-3.2]). Couples using IUI for one (HR 2.9 [1.4-5.8]), two (HR 2.0 [0.9-4.5]), and three cycles (HR 4.5 [1.8-10.9]) were more likely to achieve a pregnancy. No additional benefit was seen for couples using four or more IUI cycles (HR 1.0 [0.4-2.6]). In vitro fertilization was associated with significant benefit for couples using one (HR 2.8 [1.5-5.2]) and two cycles (HR 2.2 [1.2-4.1]). Couples using three or more IVF cycles had a non-statistically significant higher likelihood of pregnancy (HR 1.3 [0.7-2.4]). CONCLUSION(S): Cycle-based fertility treatments may offer a point of diminishing returns for infertile couples: two cycles of medications only, three cycles of IUI, and two cycles of IVF. |
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Authors:
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James F Smith; Michael L Eisenberg; Susan G Millstein; Robert D Nachtigall; Natalia Sadetsky; Marcelle I Cedars; Patricia P Katz; |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural Date: 2010-07-25 |
Journal Detail:
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Title: Fertility and sterility Volume: 95 ISSN: 1556-5653 ISO Abbreviation: Fertil. Steril. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-20 Completed Date: 2011-01-21 Revised Date: 2012-01-04 |
Medline Journal Info:
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Nlm Unique ID: 0372772 Medline TA: Fertil Steril Country: United States |
Other Details:
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Languages: eng Pagination: 79-84 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Urology, University of California-San Francisco, San Francisco, California 94143-1695, USA. smithjf@urology.ucsf.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cohort Studies Female Humans Infertility / epidemiology*, therapy* Kaplan-Meier Estimate Male Multivariate Analysis Pregnancy Pregnancy Rate* Prognosis Proportional Hazards Models Prospective Studies Reproductive Techniques, Assisted / statistics & numerical data* United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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HD37074/HD/NICHD NIH HHS; P01 HD037074-010003/HD/NICHD NIH HHS |
| Investigator | |
Investigator/Affiliation:
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Nancy Adler / ; Mary Croughan / ; Lauri Pasch / ; Steven Gregorich / ; Jonathan Showstack / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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