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Infertility

LuDane Simmons, MD and Sahil Mullick, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

Definition: failure of a couple to conceive after 1 year of normal sexual activity without contraceptives. Primary: Couple has never been pregnant. Secondary: Couple has been pregnan...

DIAGNOSIS

HISTORY

  • Complete reproductive history:

    • Age at menarche, regularity of menstrual cycle, physical development, previous methods of contraception, history of abnormal Pap smears and treatment

    • Hist...

TREATMENT

GENERAL MEASURES

  • Couples may wish to begin with simpler methods for determining ovulation and timing intercourse, depending on duration of infertility and resources available. Basal body temp...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patients should be referred to a specialist and consider more aggressive options if not successful after 3 to 6 cycles of oral ovulation induction. 

Patient Monitoring

REFERENCES

1
Tsevat DG, Wiesenfeld HC, Parks C, et al. Sexually transmitted diseases and infertility. Am J Obstet Gynecol.  2017;216(1):1–9. [View Abstract on OvidMedline]
2
Ruder EH, Hartman TJ, Re...

ADDITIONAL READING

  • Humphries L, Chang O, Humm K, et al. Influence of race and ethnicity on in vitro fertilization outcomes: systematic review. Am J Obstet Gynecol.  2016;214(2):212.e1–212.e17. [V...

CODES

ICD10

  • N97.9 Female infertility, unspecified

  • N46.9 Male infertility, unspecified

  • N97.1 Female infertility of tubal origin

  • N46.8 Other male infertility

  • N46.023 Azoospermia due to obstruction of efferen...

CLINICAL PEARLS

  • Women <35 years of age should be evaluated for infertility after failing to conceive after 1 year of unprotected intercourse, those ≥35 years should receive evaluation after 6 month...

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