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Chapter 19 - Evaluation of female infertility for the non-gynecologist

Published online by Cambridge University Press:  19 May 2010

Larry I. Lipshultz
Affiliation:
Baylor College of Medicine
Stuart S. Howards
Affiliation:
University of Virginia
Craig S. Niederberger
Affiliation:
University of Illinois, Chicago
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Summary

Reproductive endocrinologists use the concept of fecundability in addition to discussing pregnancy rates. Fecundability is a valuable clinical and scientific concept, as it creates the framework for the quantitative analysis of fertility potential. The factor affecting prognosis is the age of the female partner. An important part of the basic infertility evaluation is assessment of fallopian tube patency. A hysterosalpingogram (HSG) is the frequently utilized modality for tubal assessment. Patients who are prepared to enter into in-vitro fertilization (IVF) treatment are encouraged to undergo salpingectomy because of very low pregnancy rates after neosalpingostomy, high rate of recurrent occlusion, risk of ectopic pregnancy, and decreased success rates after IVF when hydrosalpinx is present. Ovarian reserve testing should be offered routinely to women over 35, as well as to those with unexplained infertility to respond to conventional infertility treatment, and to those contemplating assisted reproductive technologies (ART) therapy.
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Publisher: Cambridge University Press
Print publication year: 2009

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