0
October 11, 1995, Vol 274, No. 14 >
ARTICLE | October 11, 1995

A Couple With Infertility FREE

John A. Collins, MD
[+] Author Affiliations

Dr Collins is from the Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario.

This conference took place at the Obstetrics/Gynecology Grand Rounds of the Beth Israel Hospital, Boston, Mass, on May 31, 1995.

Reprint requests to Division of General Medicine and Primary Care, Beth Israel Hospital, 330 Brookline Ave, LY339, Boston, MA 02215 (Ms Walzer).

Clinical Crossroads at Boston's Beth Israel Hospital is produced and edited by Thomas L. Delbanco, MD, and Jennifer Daley, MD; Janet Walzer, MEd, is managing editor. Clinical Crossroads section editor: Margaret A. Winker, MD, Senior Editor, JAMA.


JAMA. 1995;274(14):1159-1164. doi:10.1001/jama.1995.03530140071035
Text Size: A A A
Published online
Article
References

Dr Daley  : Mrs B is a 32-year-old paralegal. Married for 5 years to Mr B, a 32-year-old manager, they have been trying to conceive since 1992. They are both members of a health maintenance organization and live in Massachusetts, where health insurance coverage of infertility and advanced reproductive technologies is mandated by the state.In good health, Mrs B has never been pregnant and used oral contraceptives for 4 years before attempting pregnancy. Her menarche was at 12 years of age, with her cycles occurring every 28 days, lasting 4 days, with spotting between day 22 and day 25. In July 1993, after 1 year of attempting to conceive, the patient was referred by her primary physician to an infertility specialist. Mrs and Mr B then sought care from Dr T, another infertility specialist. Mrs B's past medical history is unremarkable except for a family history of fibrocystic breast disease.

REFERENCES

1 +
Mosher WD, Pratt WF.  Fecundity and infertility in the United States: incidence and trends. Fertil Steril . 1991;;56:192-193.
2 +
Guideline for Practice: Unexplained Infertility . Birmingham, Ala: American Fertility Society; 1992;:1.
3 +
Collins JA, Crosignani PG.  Unexplained infertility: a review of diagnosis, prognosis, treatment efficacy and management. Int J Gynaecol Obstet . 1993;; 39:267-275.
4 +
Crosignani PG, Collins J, Cooke ID, Diczfalusy E, Rubin B.  Unexplained infertility. Hum Reprod . 1993;;8:977-980.
5 +
Li T-C, Dockery P, Rogers AW, Cooke ID.  How precise is histologic dating of endometrium using the standard dating criteria? Fertil Steril . 1989;;51:759-763.
6 +
Balasch J, Fabregues F, Creus M, Vanrell JA.  The usefulness of endometrial biopsy for luteal phase evaluation in infertility. Hum Reprod . 1992;;7:973-977.
7 +
Driessen F, Holwerda P, Putte S, Kremer J.  The significance of dating an endometrial biopsy for the prognosis of the infertile couple. Int J Fertil . 1980;;25:112-116.
8 +
Soliman S, Daya S, Collins JA, Hughes EG.  The role of luteal phase support in infertility treatment: a meta-analysis of randomized trials. Fertil Steril . 1994;;61:1068-1076.
9 +
Griffith CS, Grimes DA.  The validity of the postcoital test. Am J Obstet Gynecol . 1990;;162:616-620.
10 +
MaGuiness SD, Djahanbakhch O, Grudzinskas JG.  Assessment of the fallopian tube. Obstet Gynecol Surv . 1992;;47:587-603.
11 +
Hughes EG, Fedorkow DM, Collins JA.  A quantitative overview of controlled trials in endometriosis-associated infertility. Fertil Steril . 1993;;59:963-970.
12 +
Collins JA, Burrows EA, Willan AR.  The prognosis for live birth among untreated infertile couples. Fertil Steril . 1995;;64:22-28.
13 +
Fisch P, Casper RF, Brown SE, et al.  Unexplained infertility: evaluation of treatment with clomiphene citrate and human chorionic gonadotropin. Fertil Steril . 1989;;51:828-833.
14 +
Deaton JL, Gibson M, Blackmer KM, Nakajima ST, Badger GJ, Brumsted JR.  A randomized, controlled trial of clomiphene citrate and intrauterine insemination in couples with unexplained infertility or surgically corrected endometriosis. Fertil Steril . 1990;;54:1083-1088.
15 +
Glazener CMA, Coulson C, Lambert PA, et al.  Clomiphene treatment for women with unexplained infertility: placebo-controlled study of hormonal responses and conception rates. Gynecol Endocrinol . 1990;;4:75-83.
16 +
Harrison RF, O'Moore RR.  The use of clomiphene citrate with and without human chorionic gonadotropin. Ir Med J . 1983;;76:273-274.
17 +
Martinez AR, Bernardus RE, Voorhorst FJ, Vermeiden JPW, Schoemaker J.  Intrauterine insemination does and clomiphene citrate does not improve fecundity in couples with infertility due to male or idiopathic factors: a prospective, randomized, controlled study. Fertil Steril . 1990;;53:847-853.
18 +
Kirby CA, Flaherty SP, Godfrey BM, Warnes GM, Matthews CD.  A prospective trial of intrauterine insemination of motile spermatozoa versus timed intercourse. Fertil Steril . 1991;;56:102-107.
19 +
The American Fertility Society, Society for Assisted Reproductive Technology.  Assisted reproductive technology in the United States and Canada: 1992 results generated from The American Fertility Society/Society for Assisted Reproductive Technology Registry. Fertil Steril . 1994;;62:1121-1128.
20 +
Crosignani PG, Walters DE, Soliani A.  The ESHRE multicentre trial on the treatment of unexplained infertility: a preliminary report. Hum Reprod . 1991;;6:953-958.
21 +
Peterson CM, Hatasaka HH, Jones KP, Poulson AM, Carrell DT, Urry RL.  Ovulation induction with gonadotropins and intrauterine insemination compared with in vitro fertilization and no therapy: a prospective, non-randomized, cohort study and meta-analysis. Fertil Steril . 1994;;62:535-544.
22 +
Tanbo T, Dale PO, Abyholm T.  Assisted fertilization in infertile women with patent fallopian tubes: a comparison of in-vitro fertilization, gamete intrafallopian transfer and tubal embryo stage transfer. Hum Reprod . 1990;;5:266-270.
23 +
Leeton J, Rogers P, Caro C, Healy D, Yates C.  A controlled study between the use of gamete intrafallopian transfer (GIFT) and in vitro fertilization and embryo transfer in the management of idiopathic and male infertility. Fertil Steril . 1987;;48:605-607.
24 +
Fluker MR, Zouves CG, Bebbington MW.  A prospective randomized comparison of zygote intrafallopian transfer and in vitro fertilization-embryo transfer for nontubal factor infertility. Fertil Steril . 1993;;60:515-519.
25 +
Tournaye H, Devroey P, Camus M, Valkenburg M, Bollen N, Van Steirteghem AC.  Zygote intrafallopian transfer or in vitro fertilization and embryo transfer for the treatment of male-factor infertility: a prospective randomized trial. Fertil Steril . 1992;;58:344-350.
26 +
Yeh J, Leipzig S, Friedman EA, Seibel MM.  Results of in vitro fertilization pregnancies: experience at Boston Beth Israel Hospital. Int J Fertil . 1990;;35: 116-119.
27 +
Navot D, Bergh PA, Laufer N.  Ovarian hyperstimulation in novel reproductive technologies: prevention and treatment. Fertil Steril . 1992;;58:249-261.
28 +
Schenker JG, Ezra Y.  Complications of assisted reproduction techniques. Fertil Steril . 1994;;61:411-422.
29 +
Rossing MA, Daling JR, Weiss NS, Moore DE, Self SG.  Ovarian tumors in a cohort of infertile women. N Engl J Med . 1994;;331:771-776.
30 +
Rose G.  MRC working party on children conceived by in vitro fertilization births in Great Britain resulting from assisted conception 1978-87. BMJ . 1990;; 300:1229-1233.
31 +
Goeree R, Labelle R, Jarrell JF.  Cost-effectiveness of an in-vitro fertilization program and the costs of associated hospitalizations and other infertility treatments.  In: New Reproductive Technologies and the Health Care System: The Case for Evidence-Based Medicine . Ottawa, Ontario: Ministry of Supply and Services; 1993;:569-599.
32 +
Neumann PJ, Weinstein MC, Gharib SD.  The cost of a successful delivery with in vitro fertilization. N Engl J Med . 1994;;331:239-243.
33 +
Collins JA, Bustillo M, Visscher RD, Lawrence LD.  An estimate of the cost of in vitro fertilization services in the United States in 1995. Fertil Steril . 1995;;64:538-545.
34 +
US Congress Office of Technology. Infertility: Medical and Social Choices . Washington, DC: US Government Printing Office; 1988;:3.
35 +
Neumann PJ, Johannesson M.  The willingness to pay for in vitro fertilization: a pilot study using contingent evaluation. Med Care . 1994;;32:686-699.
36 +
Myles DG, Kimmel LH, Blobel CP, White JM, Primakoff P.  Identification of a binding site in the disintegrin domain of fertilin required for sperm fusion. Proc Natl Acad Sci U S A . 1994;;91:4195-4198.
37 +
Lessey BA, Castelbaum AJ, Sawin SW, Sun J.  Integrins as markers of uterine receptivity in women with primary unexplained infertility. Fertil Steril . 1995;;63:535-542.
38 +
Toner JP, Brzyski RG, Oehninger S, Veeck LL, Simonetti S, Muasher SJ.  Combined impact of the number of pre-ovulatory oocytes and cryopreservation on IVF outcome. Hum Reprod . 1991;;6:284-289.
39 +
Lenton EA, Cooke ID, Hooper M, et al.  In vitro fertilization in the natural cycle. Baillieres Clin Obstet Gynaecol . 1992;;6:229-245.
40 +
Paulson RJ, Sauer MV, Francis MM, Macaso TM, Lobo RA.  Factors affecting pregnancy success of human in-vitro fertilization in unstimulated cycles. Hum Reprod . 1994;;9:1571-1575.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Mosher WD, Pratt WF.  Fecundity and infertility in the United States: incidence and trends. Fertil Steril . 1991;;56:192-193.
2 +
Guideline for Practice: Unexplained Infertility . Birmingham, Ala: American Fertility Society; 1992;:1.
3 +
Collins JA, Crosignani PG.  Unexplained infertility: a review of diagnosis, prognosis, treatment efficacy and management. Int J Gynaecol Obstet . 1993;; 39:267-275.
4 +
Crosignani PG, Collins J, Cooke ID, Diczfalusy E, Rubin B.  Unexplained infertility. Hum Reprod . 1993;;8:977-980.
5 +
Li T-C, Dockery P, Rogers AW, Cooke ID.  How precise is histologic dating of endometrium using the standard dating criteria? Fertil Steril . 1989;;51:759-763.
6 +
Balasch J, Fabregues F, Creus M, Vanrell JA.  The usefulness of endometrial biopsy for luteal phase evaluation in infertility. Hum Reprod . 1992;;7:973-977.
7 +
Driessen F, Holwerda P, Putte S, Kremer J.  The significance of dating an endometrial biopsy for the prognosis of the infertile couple. Int J Fertil . 1980;;25:112-116.
8 +
Soliman S, Daya S, Collins JA, Hughes EG.  The role of luteal phase support in infertility treatment: a meta-analysis of randomized trials. Fertil Steril . 1994;;61:1068-1076.
9 +
Griffith CS, Grimes DA.  The validity of the postcoital test. Am J Obstet Gynecol . 1990;;162:616-620.
10 +
MaGuiness SD, Djahanbakhch O, Grudzinskas JG.  Assessment of the fallopian tube. Obstet Gynecol Surv . 1992;;47:587-603.
11 +
Hughes EG, Fedorkow DM, Collins JA.  A quantitative overview of controlled trials in endometriosis-associated infertility. Fertil Steril . 1993;;59:963-970.
12 +
Collins JA, Burrows EA, Willan AR.  The prognosis for live birth among untreated infertile couples. Fertil Steril . 1995;;64:22-28.
13 +
Fisch P, Casper RF, Brown SE, et al.  Unexplained infertility: evaluation of treatment with clomiphene citrate and human chorionic gonadotropin. Fertil Steril . 1989;;51:828-833.
14 +
Deaton JL, Gibson M, Blackmer KM, Nakajima ST, Badger GJ, Brumsted JR.  A randomized, controlled trial of clomiphene citrate and intrauterine insemination in couples with unexplained infertility or surgically corrected endometriosis. Fertil Steril . 1990;;54:1083-1088.
15 +
Glazener CMA, Coulson C, Lambert PA, et al.  Clomiphene treatment for women with unexplained infertility: placebo-controlled study of hormonal responses and conception rates. Gynecol Endocrinol . 1990;;4:75-83.
16 +
Harrison RF, O'Moore RR.  The use of clomiphene citrate with and without human chorionic gonadotropin. Ir Med J . 1983;;76:273-274.
17 +
Martinez AR, Bernardus RE, Voorhorst FJ, Vermeiden JPW, Schoemaker J.  Intrauterine insemination does and clomiphene citrate does not improve fecundity in couples with infertility due to male or idiopathic factors: a prospective, randomized, controlled study. Fertil Steril . 1990;;53:847-853.
18 +
Kirby CA, Flaherty SP, Godfrey BM, Warnes GM, Matthews CD.  A prospective trial of intrauterine insemination of motile spermatozoa versus timed intercourse. Fertil Steril . 1991;;56:102-107.
19 +
The American Fertility Society, Society for Assisted Reproductive Technology.  Assisted reproductive technology in the United States and Canada: 1992 results generated from The American Fertility Society/Society for Assisted Reproductive Technology Registry. Fertil Steril . 1994;;62:1121-1128.
20 +
Crosignani PG, Walters DE, Soliani A.  The ESHRE multicentre trial on the treatment of unexplained infertility: a preliminary report. Hum Reprod . 1991;;6:953-958.
21 +
Peterson CM, Hatasaka HH, Jones KP, Poulson AM, Carrell DT, Urry RL.  Ovulation induction with gonadotropins and intrauterine insemination compared with in vitro fertilization and no therapy: a prospective, non-randomized, cohort study and meta-analysis. Fertil Steril . 1994;;62:535-544.
22 +
Tanbo T, Dale PO, Abyholm T.  Assisted fertilization in infertile women with patent fallopian tubes: a comparison of in-vitro fertilization, gamete intrafallopian transfer and tubal embryo stage transfer. Hum Reprod . 1990;;5:266-270.
23 +
Leeton J, Rogers P, Caro C, Healy D, Yates C.  A controlled study between the use of gamete intrafallopian transfer (GIFT) and in vitro fertilization and embryo transfer in the management of idiopathic and male infertility. Fertil Steril . 1987;;48:605-607.
24 +
Fluker MR, Zouves CG, Bebbington MW.  A prospective randomized comparison of zygote intrafallopian transfer and in vitro fertilization-embryo transfer for nontubal factor infertility. Fertil Steril . 1993;;60:515-519.
25 +
Tournaye H, Devroey P, Camus M, Valkenburg M, Bollen N, Van Steirteghem AC.  Zygote intrafallopian transfer or in vitro fertilization and embryo transfer for the treatment of male-factor infertility: a prospective randomized trial. Fertil Steril . 1992;;58:344-350.
26 +
Yeh J, Leipzig S, Friedman EA, Seibel MM.  Results of in vitro fertilization pregnancies: experience at Boston Beth Israel Hospital. Int J Fertil . 1990;;35: 116-119.
27 +
Navot D, Bergh PA, Laufer N.  Ovarian hyperstimulation in novel reproductive technologies: prevention and treatment. Fertil Steril . 1992;;58:249-261.
28 +
Schenker JG, Ezra Y.  Complications of assisted reproduction techniques. Fertil Steril . 1994;;61:411-422.
29 +
Rossing MA, Daling JR, Weiss NS, Moore DE, Self SG.  Ovarian tumors in a cohort of infertile women. N Engl J Med . 1994;;331:771-776.
30 +
Rose G.  MRC working party on children conceived by in vitro fertilization births in Great Britain resulting from assisted conception 1978-87. BMJ . 1990;; 300:1229-1233.
31 +
Goeree R, Labelle R, Jarrell JF.  Cost-effectiveness of an in-vitro fertilization program and the costs of associated hospitalizations and other infertility treatments.  In: New Reproductive Technologies and the Health Care System: The Case for Evidence-Based Medicine . Ottawa, Ontario: Ministry of Supply and Services; 1993;:569-599.
32 +
Neumann PJ, Weinstein MC, Gharib SD.  The cost of a successful delivery with in vitro fertilization. N Engl J Med . 1994;;331:239-243.
33 +
Collins JA, Bustillo M, Visscher RD, Lawrence LD.  An estimate of the cost of in vitro fertilization services in the United States in 1995. Fertil Steril . 1995;;64:538-545.
34 +
US Congress Office of Technology. Infertility: Medical and Social Choices . Washington, DC: US Government Printing Office; 1988;:3.
35 +
Neumann PJ, Johannesson M.  The willingness to pay for in vitro fertilization: a pilot study using contingent evaluation. Med Care . 1994;;32:686-699.
36 +
Myles DG, Kimmel LH, Blobel CP, White JM, Primakoff P.  Identification of a binding site in the disintegrin domain of fertilin required for sperm fusion. Proc Natl Acad Sci U S A . 1994;;91:4195-4198.
37 +
Lessey BA, Castelbaum AJ, Sawin SW, Sun J.  Integrins as markers of uterine receptivity in women with primary unexplained infertility. Fertil Steril . 1995;;63:535-542.
38 +
Toner JP, Brzyski RG, Oehninger S, Veeck LL, Simonetti S, Muasher SJ.  Combined impact of the number of pre-ovulatory oocytes and cryopreservation on IVF outcome. Hum Reprod . 1991;;6:284-289.
39 +
Lenton EA, Cooke ID, Hooper M, et al.  In vitro fertilization in the natural cycle. Baillieres Clin Obstet Gynaecol . 1992;;6:229-245.
40 +
Paulson RJ, Sauer MV, Francis MM, Macaso TM, Lobo RA.  Factors affecting pregnancy success of human in-vitro fertilization in unstimulated cycles. Hum Reprod . 1994;;9:1571-1575.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems