What is Infertility?

 

 
What is Infertility?

  • Infertility is the result of a disease – an interruption, cessation, or disorder of body functions, systems, or organs – of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.
  • In most instances, providers do not evaluate couples or individuals for infertility until the couple has not achieved a successful  pregnancy after 12 months or more of regular unprotected intercourse. Earlier evaluation and treatment may be justified based on medical history and physical findings and is warranted after 6 months for women over age 35 years.
  • Infertility affects men and women equally.
  • Most infertility cases, about 85 to 90 percent, are treated with conventional medical therapies, such as medication or surgery.
  • In vitro fertilization and other similar treatments account for less than 3 percent of infertility services and about 0.07 percent of all U.S. health care costs.
Source: American Society for Reproductive Medicine, www.asrm.com

High Follicle Stimulating Hormone-Why Some Patients Should Not Be Excluded

    • In patients with an elevated cycle day 3 FSH level and over 40 years of age, alternatives to fertility treatments (ovum donation, adoption, or no treatment) should not be considered as first choices.(1)
    • Even with elevated FSH levels, a 16% pregnancy rate per egg retrieval may be obtained if three or more growing follicles can be seen during ovarian stimulation.(1)
    • It does not seem justified to exclude patients with normal regular cycles from treatment on the basis of the FSH value alone.(2)
      1. Bassil, S., Godin, P., Gillerot, S., Verougstraete,J.& Donnez, J.(1996). In Vitro Fertilization Outcome According to Age and Follicle-Stimulating Hormone Levels on Cycle Day 3. Journal of Assisted Reproduction and Genetics, 16(5):236-41.
      2. van Rooij IA., et al.(2003) Women older than 40 years of age and those with elevated follicle-stimulating hormone levels differ in poor response rate and embryo quality in in vitro fertilization. Fertil Steril., 79:482–8.