- Adam H Balen, professor of reproductive medicine and surgery,
- Anthony J Rutherford, consultant in reproductive medicine and surgery
- Leeds General Infirmary, Leeds LS2 9NS
- Correspondence to: A H Balen adam.balen{at}leedsth.nhs.uk
Summary points
Around 9% of couples are affected by infertility and half of them seek help
The most important determinant of a couple's fertility is the woman's age
Demographic trends to delay childbearing mean that more older women are having problems trying to conceive
Lifestyle has a profound effect on fertility—obesity, smoking, alcohol, and recreational drugs negatively affect the chance of conception and pregnancy outcome
Male infertility may be increasing, possibly because of environmental pollution
Success rates of in vitro fertilisation may improve with a better understanding of embryo physiology
Around 9% of couples are involuntarily childless. At least a quarter of couples experience unexpected delays in achieving their desired family size,1 although only a half seek treatment. In recent years, publicity about infertility treatments has increased, and couples are now more willing to seek advice. The first of these two brief reviews covers the main causes of infertility, with particular reference to advances in the past five years; the second review will look at polycystic ovary syndrome and anovulatory infertility.
The role of the general practitioner is to initiate the investigation of both partners and ensure timely onward referral to a specialist clinic. Treatments for infertility are never far from the public eye, often courting controversy and ethical dilemmas. This article aims to provide general practitioners with a balanced and evidence based overview of the latest advances and where they fit into current practice.
Sources and selection criteria
We referred to the Cochrane database of systematic reviews, NICE guidelines for the investigation and management of infertility (2004), and our knowledge of the current literature.
Ongoing research questions and projects
How can we increase the success rate of assisted conception while minimising the risks of multiple pregnancy by the transfer of single embryos?
How can fertility be preserved in the context of cancer treatments that cause sterility or as insurance …
Sign in
Personal subscribers, sign in here:
Article access
Article access for 1 day
Purchase this article for £20 $30 €32*
The PDF version can be downloaded as your personal record
CiteULike
Connotea
Del.icio.us
Digg
Facebook
Reddit
Technorati
Twitter
Stumbleupon
Rapid responses
Latest Responses
The decline in the breast cancer incidence is 1.2% and it is not significant.
Published 10 February 2012
'twas ever thus
Published 10 February 2012
The value of historic human remains
Published 10 February 2012
In Praise of British Literature
Published 10 February 2012
Is real shared decision making possible?
Published 10 February 2012
Most responses
Does anyone understand the government’s plan for the NHS? (17 responses)
Published 17 Jan 2012
Bad medicine: medical nutrition (15 responses)
Published 18 Jan 2012
Shared decision making: really putting patients at the centre of healthcare (7 responses)
Published 27 Jan 2012
Why legislation is necessary for my health reforms (7 responses)
Published 1 Feb 2012
Search for evidence goes on (5 responses)
Published 17 Jan 2012