LIFE TABLE ANALYSIS OF PREGNANCY RATES IN A GENERAL INFERTILITY POPULATION RELATIVE TO OVARIAN RESERVE AND PATIENT AGE

This study evaluated the impact of age and ovarian reserve status on c umulative pregnancy rates, Approximately 1200 women from a general inf ertile population underwent ovarian reserve screening with the clomiph ene citrate challenge test in the first few months of their initial ev aluation, All patients then underwent a thorough infertility evaluatio n with therapy appropriate for their specific diagnoses. Patients with evidence of tubal disease, peritoneal adhesive disease, or male facto r were eliminated. The 588 remaining patients were evaluated based on their age and ovarian reserve status, and their long-term pregnancy ra tes were compared using life table analyses. There was a dramatic decr ease in pregnancy rates associated with an abnormal clomiphene citrate challenge test which was uniformly poor independent of age. Patients with normal ovarian reserve had much higher pregnancy rates, but a sig nificant age-related decline in pregnancy rates was clearly identified . We conclude that women with evidence of diminished ovarian reserve h ave uniformly poor pregnancy rates independent of their age, but that age remains an important prognostic factor among those with a normal o varian reserve, The combined use of maternal age and ovarian reserve s creening should be used when counselling individual patients regarding their long-term prognoses for conception.