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Age-related natural fertility outcomes in women over 35 years: A systematic review and individual participant data meta-analysis

Human Reproduction Aug 07, 2020

Chua SJ, Danhof NA, Mochtar MH, et al. - Researchers investigated the rate of natural conception resulting in ongoing pregnancy or livebirth over 6–12 months for infertile women of age ≥ 35 years via performing a systematic review with individual participant data (IPD) meta-analysis. They searched PubMed, MEDLINE, EMBASE, the Cochrane Library, clinicaltrials.gov and identified nine studies (seven cohort studies and two RCTs) (n = 4,379 women of at least age 35 years) for inclusion in this work. Composite primary outcome of ongoing pregnancy or livebirth was reported in 429 women (9.8%) over a median follow-up of 5 months (25th to 75th percentile: 2.5–8.5 months). Per findings, women aged 35 years and above still had clinically relevant natural conception rates; these were significantly higher in women with unexplained infertility compared to those with other diagnoses. Based on findings, they emphasize encouraging women attending fertility services to pursue natural conception while waiting for treatment to commence and after treatment if it is unsuccessful.

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