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Wednesday, 3 July, 2002, 12:00 GMT 13:00 UK
Women urged 'not to rush IVF treatment'
Scientists urged women to be patient
Most women - even those in their late thirties - will conceive naturally within two years of trying, research suggests.

A study, by a team from the US National Institute of Environmental Health Sciences in North Carolina, showed that at least 50% of healthy women who do not conceive in the first year will conceive in the second year.

Researchers found that even when a woman was aged between 35 and 39, fewer than one in 10 failed to conceive after two years - unless the male partner was over 40.

Women failing to conceive
19-26 years 8%
27-34 years 13-14%
35-39 years 18%
Lead researcher Dr David Dunson told the annual conference of the European Society of Human Reproduction and Embryology in Vienna the findings - based on a study of 782 couples - suggested women should be patient.

He added that doctors should not intervene too fast with assisted reproductive techniques unless there are known reasons for a couple not conceiving naturally within a year.

Dr Dunson said recent research undertaken by his team showed that fertility in women started to decline as early as the late 20s and for men from their late 30s.

However, while this means that it may take longer to get pregnant, it does not mean that pregnancy becomes impossible.

Dr Dunson said: "On average the time to pregnancy increases with the age of the woman.

"The percentage failing to conceive within a year ranged from 8% for 19-26-year-olds to 13 to 14% for 27 to 34-year-olds to 18% for 35-39-year-olds.

"But, regardless of age, most of the women who failed to conceive within the first 12 cycles conceived in the next 12.

"Only 3% of 19 to 26-year-olds, 6% of 27 to 34-year-olds and 9% of 35 to 39-year-olds failed to conceive in the second year, provided the male partner was aged under 40."

Variation in fertility

Dr Dunson said male age was also important.

It meant that the proportion of women who failed to become pregnant after one year of trying for those aged between 35 and 39 rose from 18% to 28% if the male partner was over 40.

After the second year, the figure was 9% with male partners under 40 and 16% with male partners over 40.

However, Dr Dunson stressed there was a big variation in natural fertility, and that many couples with below average, but normal fertility may fail to conceive within the first year, but will be successful in the second.

He said it was important for doctors to avoid recommending assisted reproduction too soon because there were well-documented side effects.

"A lot of people interpreted data showing a decline in fertility in the late 20s and said maybe people should be rushed into assisted reproduction, but declining fertility does not indicate an inability to reproduce, just a delay in conceiving most of the time."

But he added: "Women will continue to worry and feel they should to do something about it. I think it will be difficult to get the message across."

One in five couples who undergo IVF treatment has unexplained fertility problems and cannot be helped to get pregnant.

Fertility treatment can result in an increased risk of multiple pregnancies, pregnancy complications, low birth weight, major birth defects and long-term disability among surviving infants.

Not only does the success of the techniques decrease as a woman gets older, the chances of side effects increase.

At present clinical infertility is diagnosed as an inability to get pregnant within one year.

Dr Dunson suggested that the definition should now be changed.

Professor Ulrick Kvist, from the Karolinska Institute in Sweden, said the problem of rushing people into fertility treatment had been minimised in Nordic countries by testing men and women's fertility if they had failed to conceive.

If no problems with ovulation or sperm count were apparent, couples were told to go away and continue to try to conceive naturally.

Reports from the 2002 Eshre conference in Vienna

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