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Evaluation and Management of Infertility in Women: The Internists' Role

Karen Rosene-Montella, MD; Erin Keely, MD; Steven A. Laifer, MD; and Richard V. Lee, MD
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From Brown University School of Medicine, Providence, Rhode Island; University of Ottawa, Ottawa, Ontario, Canada; Yale University School of Medicine, New Haven, Connecticut; and State University of New York at Buffalo, Buffalo, New York.

Requests for Single Reprints: Karen Rosene-Montella, MD, Brown University School of Medicine, Women and Infants Hospital, 101 Dudley Street, Suite 3356, Providence, RI 02905.

Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Dr. Rosene-Montella: Brown University School of Medicine, 101 Dudley Street, Suite 3356, Providence, RI 02905.

Dr. Keely: University of Ottawa, Ottawa Hospital, General Site, 501 Smyth Road, Room LM13, Ottawa, Ontario K1H 8L6, Canada.

Dr. Laifer: Bridgeport Hospital, 267 Grant Street, Box 5000, Bridgeport, CT 06610.

Dr. Lee: State University of New York at Buffalo, 7664 East Quaker Road, Orchard Park, NY 14127.

Ann Intern Med. 2000;132(12):973-981. doi:10.7326/0003-4819-132-12-200006200-00008
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Interventions for infertility have greatly increased in number and sophistication. Women with multiple medical problems and women near or beyond menopause are now able to conceive. The internist will be called on to assess the risk that infertility interventions pose and to counsel patients accordingly. Knowledge of the medical illnesses associated with infertility, the types of infertility treatments available, and the medical complications of these interventions are required to properly assess this risk. Medical complications of infertility interventions can be direct effects of related drugs and technologies and indirect consequences of the induced pregnancy, multiple gestation, or associated medical conditions. This article reviews the definitions and scope of infertility, the interventions used for treatment of infertility, the medical complications of these interventions, the potential risks of fertility treatment in women unable to conceive spontaneously, and important issues for preconception counseling.







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