Fertility trends and comparisons in a historical cohort of US women with primary infertility

Abstract

Background There is growing interest in long-term outcomes following infertility and infertility treatment. However, there are few detailed longitudinal cohorts available for this work. This study aimed to assemble a historical cohort of women with primary infertility and age-matched controls to evaluate fertility trends, sequelae, and sociodemographic differences. Described here are cohort group characteristics and associated reproductive trends over time. Methods A population-based historical cohort was created using the Rochester Epidemiology Project (REP) record-linkage system (Olmsted County, MN). The cohort included women aged 18–50 with a diagnosis of primary infertility between January 1, 1980, and December 31, 1999. As part of a case–control study, we identified 1:1 age-matched female controls from the same community and era. Results A total of 1001 women with primary infertility and 1001 age-matched controls were identified. The women with primary infertility were significantly more likely to be married, college educated, use barrier contraception, and non-smokers compared to age-matched controls. The incidence of primary infertility increased from 14 to 20 per 10,000 person years from 1980–1985 to 1995–1999. Ovulatory dysfunction and unexplained infertility were the most common causes of primary infertility and clomiphene was the most widely used fertility medication. Rates of in vitro fertilization (IVF) increased from 1.8% during 1980–1985 to 26.0% during 1995–1999. Conclusion Women with primary infertility were found to have unique sociodemographic characteristics compared to age-matched control women, which is consistent with previous research. The incidence of diagnosed primary infertility increased from 1980 to 1999, as did use of IVF.

Women With a History of Primary Infertility and Increased Rates of Bilateral Oophorectomy

“…Our previous study highlighted that characteristics of our cohort of women with primary infertility are consistent with other studies of women with primary infertility, supporting its use as a representative sample for future study. 9 Although the length of follow-up and number of women included in our cohort contribute to the strength and effect of our findings, our study is not without limitations. In our analysis stratified by the primary infertility indication, particularly for those with endometriosis as the indication, some models may be considered overfit using the rule of thumb of 10-15 events per each covariate included in the regression model.…”

“…12 This study was deemed IRB-exempt because it included secondary use of information (chart review). A detailed description of the cohort used in this study has been published previously 9 and is summarized here. A total of 3,489 women aged 18-50 years with at least one diagnosis code for infertility were identified in the REP. By manual chart review, a cohort of 1,001 women had a confirmed diagnosis of primary infertility.…”

“…In this study, we used the Mayo Clinic Primary Infertility cohort, a population-based sample of women with primary infertility, and age-matched women in a referent group to evaluate the association between primary infertility and subsequent risk of gynecologic surgery, specifically hysterectomy and oophorectomy. 9 This association, if present, was hypothesized to differ by underlying infertility diagnosis and whether a woman was ever pregnant.…”

Detection of Sperm DNA Integrity and Some Immunological Aspects in Infertile Males

“…The origin of IgA present in the sperm and pre-ejaculate has yet to be confirmed. However, it appears that both local syntheses, primarily in the penile urethra and circulation, contribute to the Ig pool in these fluids, based on the molecular characteristics (Chantler, Sharma and Sharman, 1989;Sadecki, et al, 2022). The sperm parameters such as total progressive sperm motility/ejaculate and round cells count were significantly correlated with DFI that was agreed by a previous study, whereas the other sperm parameters such as normal sperm morphology and the sperm count did not correlate with DFI.…”

Real-world prescription patterns for reproductive assistance patients in China: A trend analysis from 2016 to 2020

“…The most common reasons for primary infertility were ovulatory dysfunction and unexplained infertility, whereas clomiphene has been prescribed most widely among fertility drug ( Sadecki et al, 2022 ). ART development and administration can considerably raise the clinical pregnancy rate.…”