STDs, IVF, and Barrier Contraception-Reply

Michael J. Rosenberg, MD, MPH; Daniel W. Cramer, MD, DSc; Paul J. Feldblum, MSPH
JAMA. 1987;258(13):1729-1730. doi:10.1001/jama.1987.03400130043013.
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In Reply.—  Although not all IVFs are performed because of sterility resulting from sexually transmitted diseases (STDs), we agree that greater emphasis on preventive medicine is in order. In fact, those women seeking IVF who were rendered sterile represent a small fraction of the estimated $2.6 billion cost of pelvic inflammatory disease in 1984,1 to say nothing of the cost in human suffering.Prevention of STDs is particularly important because a small increase in the use of measures that protect against STDs prevents disproportionately large numbers of cases. Based on estimates of the protection of barrier methods against gonorrhea, for example, even if only 4% or more of the population at risk uses measures that are 50% effective in preventing infection, a steady decrease in the number of new cases will result (Figure).2 If a higher percentage of the population uses such measures, the incidence of gonorrhea will


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