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Women’s age and total motile normal morphology sperm count predict fecundability: a prospective cohort study
  1. Mei Ting Lam1,2,
  2. Hang Wun Raymond Li1,2,3,
  3. Ching Yin Grace Wong1,3,
  4. William Shu Biu Yeung1,
  5. Pak Chung Ho1,
  6. Ernest Hung Yu Ng1,2
  1. 1 Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
  2. 2 Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Yau Ma Tei, Hong Kong
  3. 3 The Family Planning Association of Hong Kong, Wan Chai, Hong Kong
  1. Correspondence to Dr Mei Ting Lam, Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Yau Ma Tei, Hong Kong; lmt256{at}


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.

  • infertility
  • counselling
  • family planning service provision
  • natural family planning

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  • Contributors HWRL, WSBY, PCHO and EHYN conceived and designed the study. MTL, HWRL, GCYW and EHYN supervised subject recruitment and follow-up. MTL analysed the data, interpreted the results and drafted the manuscript. All authors provided critical revisions and approved the final manuscript prior to submission.

  • Funding This study was supported by internal research funding from the Department of Obstetrics and Gynaecology, The University of Hong Kong.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval was obtained from both the Institutional Review Board of the University of Hong Kong and the Hospital Authority Hong Kong West Cluster. Approval was also obtained from the Health Services Subcommittee, Family Planning Association of Hong Kong.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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