Spontaneous pregnancies and determinant factors in infertility: A cross-sectional study


Background: The phenomenon of infertility may be derived from different factors - either in males or females or both genders, including few unexplained factors. It is generally managed by medical and surgical treatments.

Objective: To find a relation of occurrence of spontaneous pregnancy (SP) with effective factors in infertility.

Materials and Methods: This cross-sectional study was conducted at two referral infertility centers (university and privacy center) in the southwest of Iran from March 2015 and March 2016 on 655 infertile couples, who were divided in two groups of with (n = 31) and without (n = 624) SP. The variables included female and male age, male smoking, male job, the place of living, the causes of infertility, the type and duration of infertility, and the subgroups of infertility causes.

Results: Infertility may be caused due to both male- and female- related factors (47.5%). While female-related infertility was found in 31.5%, male-related infertility in 14.5%, and infertility due to unexplained factors in 6.6% of our patients. The rate of SP was 4.7%, which had a significant relation with the duration of infertility (p = 0.01), with women’s age (p = 0.048), unexplained infertility (p = 0.001), and husband’s job (p = 0.004).

Conclusion: The occurrence of SP in infertile couples was related to age of the female partner, the duration of unexplained infertility, and the male partner’s job.

Key words: Male infertility, Female infertility, Spontaneous pregnancy, Epidemiology, Etiology.

[1] Szamatowicz M, Szamatowicz J. Proven and unproven methods for diagnosis and treatment of infertility. Adv Med Sci 2020; 65: 93–96.

[2] Mital P, Shefali J, Dinesh J, Bhavesh P, Nandini P, Priti V, et al. Prevalence of different factors responsible for infertility. Res J Recent Sci 2012; 207: 211.

[3] Mohammed-Durosinlorun A, Adze J, Bature S, Abubakar A, Mohammed C, Taingson M, et al. Use and pattern of previous care received by infertile Nigerian women. Fertil Res Pract 2019; 5: 14–21.

[4] Khalili MA, Kahraman S, Ugur MG, Agha-Rahimi A, Tabibnejad N. Follow up of infertile patients after failed ART cycles: a preliminary report from Iran and Turkey. Eur J Obstet Gynecol Reprod Biol 2012; 161: 38–41.

[5] Centola GM. Semen assessment. Urol Clin North Am 2014; 41: 163–167.

[6] Saharkhiz N, Nikbakht R, Hemadi M. Ketotifen, a mast cell blocker improves sperm motility in asthenospermic infertile men. J Hum Reprod Sci 2013; 6: 19–22.

[7] Chunyan G, Bin P, Ping Y, Yue Z, Yang X, Hongju T, et al. Assessment of the Influence on Spontaneous Pregnancy of Hysterosalpingo-Contrast Sonography. BioMed Res Int 2018; 2018: 1–8.

[8] Calik-Ksepka A, Grymowicz M, Bronkiewicz W, Urban A, Mierzejewski K, Rudnicka E, et al. Spontaneous pregnancy in a patient with premature ovarian insufficiency- case report. Prz Menopauzalny 2018; 17: 139–140.

[9] Van Der Steeg JW, Steures P, Eijkemans MJC, Habbema JDF, Hompes PGA, Kremer JAM, et al. Role of semen analysis in subfertile couples. Fertil Steril 2011; 95: 1013– 1019.

[10] Righarts AA, Gray A, Dickson NP, Parkin L, Gillett WR. Resolution of infertility and number of children: 1386 couples followed for a median of 13 years. Hum Reprod 2017; 32: 2042–2048.

[11] Troude P, Bailly E, Guibert J, Bouyer J, De La Rochebrochard E, Group D. Spontaneous pregnancies among couples previously treated by in vitro fertilization. Fertil Steril 2012; 98: 63–68.

[12] Frangez HB, Korošec S, Pozlep B, Jancar N, Salamun V, Vogler A, et al. Spontaneous pregnancy rates after reproductive surgery. Reprod Biomed Online 2017; 35: 165–173.

[13] Tanacan A, Beksac MS. Spontaneous pregnancies in patients with at least one failed IVF cycle after the management of autoimmune disorders, hereditary thrombophilia, and methylation disorders. JBRA Assist Reprod 2019; 23: 361–366.

[14] Custers IM, Van Rumste MME, Van Der Steeg JW, Van Wely M, Hompes PGA, Bossuyt P, et al. Long-term outcome in couples with unexplained subfertility and an intermediate prognosis initially randomized between expectant management and immediate treatment. Hum Reprod 2012; 27: 444–450.

[15] ESHRE Capri Workshop Group. A prognosis-based approach to infertility: understanding the role of time. Hum Reprod 2017; 32: 1556–1559.

[16] Barrett ES, Vitek W, Mbowe O, Thurston SW, Legro RS, Alvero R, et al. Allostatic load, a measure of chronic physiological stress, is associated with pregnancy outcomes, but not fertility, among women with unexplained infertility. Hum Reprod 2018; 33: 1757– 1766.

[17] Van Eekelen R, Scholten I, Tjon-Kon-Fat RI, van der Steeg JW, Steures P, Hompes P, et al. Natural conception: repeated predictions over time. Hum Reprod 2017; 32: 346–353.

[18] Volgsten H, Schmidt L. Live birth outcome, spontaneous pregnancy and adoption up to five years after undergoing assisted reproductive technology treatment. Acta Obstet Gynecol Scand 2017; 96: 954–959.

[19] Bui BN, Torrance HL, Janssen C, Cohlen B, de Bruin JP, den Hartog JE, et al. Does endometrial scratching increase the rate of spontaneous conception in couples with unexplained infertility and a good prognosis (Hunault > 30%)? Study protocol of the SCRaTCHOFO trial: a randomized controlled trial. BMC pregnancy and Childbirth 2018; 18: 511–519.

[20] de Carvalho BR, Barcelos IDES, de Medeiros SF, Benetti- Pinto CL, Yela DA, Nácul AP, et al. Increasing the Chances of Natural Conception: Opinion Statement from the the Brazilian Federation of Gynecology and Obstetrics Associations-FEBRASGO-Committee of Gynecological Endocrinology. Rev Bras Ginecol Obstet 2019; 41: 183–190.