Moderate drinking: no impact on female fecundity.

OBJECTIVE: To determine the effect of moderate alcohol intake on probability of conception. DESIGN: Prospective cohort study. SETTING: Normal healthy women enrolled in an artificial donor insemination program. PATIENTS: Women starting artificial donor insemination for the very first time were selected. INTERVENTIONS: Alcohol exposure was measured through a self-administered questionnaire at intake of study. MAIN OUTCOME MEASURE: A first positive pregnancy test as indicative for conception. RESULTS: Women with moderate alcohol intake had a slightly higher, though not significant, probability of conception compared with nondrinkers (Hazard Ratio 1.20; 95% confidence interval 0.90 to 1.60). CONCLUSION: Moderate alcohol intake has no negative impact on female fecundity.

Fat and female fecundity: prospective study of effect of body fat distribution on conception rates.

OBJECTIVES: To study the effect of body fat distribution in women of reproductive age on fecundity. DESIGN: Prospective cohort study of all women who had entered a donor insemination programme. SETTING: One fertility clinic serving a large part of the midwest of the Netherlands. SUBJECTS: Of 542 women attending the clinic for artificial insemination for the first time, 500 women were eligible for study. MAIN OUTCOME MEASURES: Probability of conception per cycle and number of insemination cycles before pregnancy or stopping treatment. RESULTS: A 0.1 unit increase in waist-hip ratio led to a 30% decrease in probability of conception per cycle (hazard ratio 0.706; 95% confidence interval 0.562 to 0.887) after adjustment for age, fatness, reasons for artificial insemination, cycle length and regularity, smoking, and parity. Increasing age was significantly related to lower fecundity (p < 0.05); very lean and obese women were less likely to conceive (p < 0.10) as were women with subfertile partners (p < 0.10). All other exposure variables were not significantly related to fecundity. CONCLUSIONS: Increasing waist-hip ratio is negatively associated with the probability of conception per cycle, before and after adjustment for confounding factors. Body fat distribution in women of reproductive age seems to have more impact on fertility than age or obesity.

Delaying childbearing: effect of age on fecundity and outcome of pregnancy.

OBJECTIVES: To study the age of the start of the fall (critical age) in fecundity; the probability of a pregnancy leading to a healthy baby taking into account the age of the woman; and, combining these results, to determine the age dependent probability of getting a healthy baby. DESIGN: Cohort study of all women who had entered a donor insemination programme. SETTING: Two fertility clinics serving a large part of The Netherlands. SUBJECTS: Of 1637 women attending for artificial insemination 751 fulfilled the selection criteria, being married to an azoospermic husband and nulliparous and never having received donor insemination before. MAIN OUTCOME MEASURES: The number of cycles before pregnancy (a positive pregnancy test result) or stopping treatment; and result of the pregnancy (successful outcome). RESULTS: Of the 751 women, 555 became pregnant and 461 had healthy babies. The fall in fecundity was estimated to start at around 31 years (critical age); after 12 cycles the probability of pregnancy in a woman aged greater than 31 was 0.54 compared with 0.74 in a woman aged 20.31. After 24 cycles this difference had decreased (probability of conception 0.75 in women greater than 31 and 0.85 in women 20.31). The probability of having a healthy baby also decreased--by 3.5% a year after the age of 30. Combining both these age effects, the chance of a woman aged 35 having a healthy baby was about half that of a woman aged 25. CONCLUSION: After the age of 31 the probability of conception falls rapidly, but this can be partly compensated for by continuing insemination for more cycles. In addition, the probability of an adverse pregnancy outcome starts to increase at about the same age.

PIP: This study examined the age of the start of the fall (critical age) in fecundity, the probability of a pregnancy leading to a healthy baby taking into account the age of the women, and, by combining all of the results, the determination of the age-dependent probability of getting a healthy baby. 2 fertility clinics serving a large part of the Netherlands provided the 751 women who fulfilled the selection criteria. In this cohort study of all women who entered a donor insemination program, those who fulfilled the selection criteria were married to azoospermic husbands, were nulliparous, and never received donor insemination previously. Main outcome measures studied were the number of cycles prior to a pregnancy (positive pregnancy result) or the cessation of treatment and the result of the pregnancy (successful outcome). Of 751 women, 555 became pregnant and 461 had healthy babies. The drop in fecundity was estimated to begin at around age 31 (critical age); after 12 cycles, the probability of pregnancy in a woman age 31 was 0.54 compared with 0.74 in a woman age 20-31. After 24 cycles, this difference had decreased (probability of conception 0.75 in women 31 and 0.85 in women age 20-31). The probability of having a healthy baby also decreased, by 3.5% a year after the age of 30. Combining both of these age effects, the chance of a woman age 35 having a healthy baby was about 1.2 that of a woman age 25. After the age of 31, the probability of conception falls rapidly; however, this can be compensated for partly by continuing insemination for more cycles. In addition, the probability of an adverse pregnancy outcome begins to increase at about the same age.

The study of risk habits in reproductive and perinatal epidemiologic research: the use of a donor inseminated population of women.

In this study we assess whether a population of donor inseminated women (ADI) provides an efficient alternative to an open population of women of reproductive age to study the effects of risk habits (cigarette smoking and alcohol consumption) on reproductive and perinatal health. An ADI population can be prospectively monitored before and after pregnancy; women enter the programme because of their husband's infertility. In the pilot clinic every couple asking for first insemination was requested to fill in a self-administered questionnaire on risk habits and the use of medicine. Medical histories of both the man and woman were taken. In 1986 and 1987, 519 women entered the programme. The response rate was 95%. Distribution of the exposure variables of the women currently smoking (52%) and currently drinking (68%) compared well with a general population survey from the town of Rotterdam. With regard to their risk habits and reproductive health, the population of women married to totally infertile men seems representative of women of reproductive age from an open population.

Arbovirus infections in Dutch military personnel stationed in Surinam: further studies

Serum specimens of Dutch military personnel were taken immediately after arrival in Surinam and again, one year later, just prior to departure. A total of 500 paired serum specimens covering the period February 1962-1964 were received at the Trinidad Regional Virus Laboratory. Screening HIV tests were done with 5 group A antigens, 1 group B antigen, 4 group C antigens and 1 Bunyamwera group antigen (Cache Valley). A total of 34 converters were found with antigens prepared from Trinidadian and Surinamese Venezuelan equine encephalitis strains. With Mayaro antigen 7 converters were found. Sera positive to Una and Paramaribo virus antigens were positive to Mayaro also with the highest titer to the latter antigen. With Caraparu antigens 14 converters were found, with Restan antigen 17 and with antigen of a Surinamese Oriboca strain 8. No conversions were discovered with an antigen prepared with a Trinidadian Oriboca strain. An additional five serum pairs showed conversions with more than one of the group C antigens. With St. Louis encephalitis antigen not more than 5 serum pairs showed conversion. With Cache Valley antigen conversion was found in only one serum pair. The data indicate that infections with VEE, Mayaro and the group C agents tended to occur in small epidemics (AU)

Arbovirus infections in Dutch military personnel stationed in Surinam: a preliminary study

In a preliminary study conducted in 1961-1962, sera from 374 soldiers of Royal Netherlands Army stationed in Surinam were examined for presence ao anti-bodies to arthropod-borne viruses in serological groups A, B and C. From many of these individuals paired specimens, taken one year apart were available. It was found that the rate of infection per 100 soldier-years of exposure was 5.3 with Mayaro virus 2.4 with group B agents, and 2.1 with a Caraparu-like virus from Trinidad, 34053-I. The clinical picture in six cases of presumed Mayaro infection is described