Bleeding and spontaneous abortion after therapy for infertility

Objective: To determine the incidence of early pregnancy bleeding and spont aneous abortion (SAB) after various treatments for infertility and to asses s whether bleeding is predictive of SAB. Design: An historic cohort study of women who conceived after various treat ments. Setting: Hospital-based private practice. Patient(s): We studied 418 patients in whom 500 consecutive clinical pregna ncies occurred. Intervention(s): Patients were grouped according to the method of conceptio n: ovulation induction, IVF, and other. The latter category included interv entions not requiring ovulation induction, such as surgery and insemination . 4 fourth group of subjects who conceived independently of treatment was u sed as the control, Main Outcome Measure(s): Bleeding and pregnancy outcome (SAB, ectopic pregn ancy, or ongoing pregnancy). Result(s): Rates of SAB did not differ among the treatment groups. SAB occu rred significantly more often after bleeding than when bleeding did not occ ur (30.8% versus 19.8%. respectively). Bleeding was predictive of SAB only in patients <35 years old (odds ratio 2.4). Conclusion(s): Infertile women who conceive after reproductive therapy are not at increased risk for SAB compared with women who conceive naturally. T here appears to be no association between previous diagnosis ol treatment a nd the occurrence of SAB in previously infertile women. Bleeding is associa ted with a twofold relative risk of SAB. (Fertil Steril(R) 2000;74:504-8. ( C) 2000 by American Society for Reproductive Medicine.).