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CLINICIAN'S CORNER
Diagnosis and Management of Female Infertility
Samuel Smith, MD;
Samantha M. Pfeifer, MD;
John A. Collins, MD
JAMA. 2003;290:1767-1770.
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INTRODUCTION
Infertility, defined as 1 year of attempted conception without success, is one of the most prevalent chronic health disorders involving young adults.1 Affecting 6 million or more US couples, infertility is clinically distinct from recurrent spontaneous pregnancy loss.1 Since 1978, the management of female infertility has been transformed by in vitro fertilization (IVF). Intracytoplasmic sperm injection (ICSI), first reported as an IVF laboratory technique in 1992, has similarly changed the management of male infertility. In vitro fertilization and ICSI have increased knowledge of the mechanisms of fertilization and implantation, leading to better awareness of potential fertility defects before and after fertilization, as well as possible errors in embryonic development. The use of IVF and ICSI remains low, however, because of the cost and complexity of the treatment.
Diagnostic Assessment
Clinical evaluation of infertility is indicated if a pregnancy has . . . [Full Text of this Article]
Prognosis
Ovulation Disorders
Tubal Infertility
Endometriosis
Unexplained Infertility
In Vitro Fertilization
Topical Female Infertility Issues
Author Affiliations: Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, Md (Dr Smith); Department of Obstetrics and Gynecology, University of Pennsylvania Medical School, Philadelphia (Dr Pfeifer); and Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario (Dr Collins).
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