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Feature Article

The infertile couple: assessment and treatment options

Alison Gee, Robert Jansen

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Abstract

The number of couples seeking infertility therapy is increasing as treatment options improve and women postpone starting a family. GPs are ideally placed to perform initial investigations, focusing on tests of ovulation, sperm production, tubal patency and uterine structure.

Key Points

  • The number of couples seeking advice on infertility is increasing, as treatment options improve and as women postpone starting a family.
  • Assessment of infertility should generally begin if a couple has failed to conceive after one year or more of regular unprotected intercourse; investigation should start earlier if there are firm clinical indications of underlying pathology.
  • GPs can perform initial investigations, focusing on tests of ovulation, sperm production, tubal patency and uterine structure.
  • These investigations can distinguish between sterility (i.e. no chance of getting pregnant without help) and subfertility (i.e. some hope of pregnancy without treatment).
  • The treatment of infertility can be cause-based (the more clear cut the cause, the more effective its correction will be) or ‘symptomatic’ (when IVF is used to secure the wanted pregnancy more directly).

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