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Infertility

Sharon L. Koehler, DO, FACS and Sonia Rivera-Martinez, DO, FACOFP Reviewed 06/2018
 


BASICS

DESCRIPTION

Definition: failure of a couple to conceive after ≥12 months of regular unprotected intercourse or after ≥6 months if the woman is ≥35 years. Primary: Couple has never been pregnant....

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

    • Hi...

TREATMENT

GENERAL MEASURES

  • Be aware of insurance coverage for each patient. Be mindful of the couple’s emotional state: Depression, anger, anxiety, and marital discord are common. Many patients benefit...

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, R...

ADDITIONAL READING

  • Declercq E, Luke B, Belanoff C, et al. Perinatal outcomes associated with assisted reproductive technology: the Massachusetts Outcomes Study of Assisted Reproductive Technologies (M...

SEE ALSO

  • Amenorrhea; Endometriosis; Infertility; Metabolic Syndrome; Polycystic Ovarian Syndrome (PCOS)

  • Algorithm: Infertility

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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