Women's age and total motile normal morphology sperm count predict fecundability: a prospective cohort study

BMJ Sex Reprod Health. 2020 Oct;46(4):279-286. doi: 10.1136/bmjsrh-2020-200639. Epub 2020 Jul 27.

Abstract

Objective: This study investigated the role of women's age, serum anti-Müllerian hormone (AMH) level and semen parameters in predicting fecundability.

Methods: This was a prospective cohort study on couples attending for preconceptional health check. Occurrence of conception at 1 year after ceasing contraception and time to pregnancy were noted by telephone follow-up. The women's age, serum AMH level and total motile normal morphology sperm count (TMNC) were compared between those who conceived and those who did not after 1 year; their independent predictive value on conception at 1 year was analysed by logistic regression. Among those conceiving within 1 year, Spearman's correlations between time to pregnancy and the clinical parameters were studied.

Results: Of the 100 couples analysed, we found younger age of the women (p=0.008), higher serum AMH level (p=0.038) and higher TMNC (p=0.015) in those that conceived within 1 year. Multivariate logistic regression found that women's age (OR 0.867, 95% CI 0.761 to 0.988, p=0.032) and TMNC (OR 1.089, 95% 1.001-1.185, p=0.047), but not serum AMH level, significantly predicted conception within 1 year. Among those that conceived within 1 year, none of the parameters analysed were correlated with time to pregnancy within 1 year.

Conclusions: Women's age and TNMC are significant independent predictors of conception within 1 year. No parameter was shown to predict the time to pregnancy within 1 year. This finding can aid preconceptional counselling of couples who are planning for pregnancy.

Keywords: counselling; family planning service provision; infertility; natural family planning.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors*
  • Anti-Mullerian Hormone / analysis
  • Anti-Mullerian Hormone / blood
  • Cohort Studies
  • Female
  • Fertility / physiology*
  • Humans
  • Male
  • Middle Aged
  • Pregnancy
  • Prospective Studies
  • ROC Curve
  • Semen / microbiology
  • Sperm Count / methods
  • Statistics, Nonparametric

Substances

  • Anti-Mullerian Hormone