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The Progressive Simplification of the Infertility Evaluation

Pavone, Mary Ellen MD*; Hirshfeld-Cytron, Jennifer E. MD; Kazer, Ralph R. MD

Obstetrical & Gynecological Survey: January 2011 - Volume 66 - Issue 1 - p 31-41
doi: 10.1097/OGX.0b013e31821288a4

Objective. With the advent of evidence-based medicine, much of the complex testing that infertile couples used to undergo is no longer recommended as part of the routine evaluation. Examples of tests no longer implemented include the postcoital test, Rubin test of tubal patency, endometrial biopsy, sperm antibody testing, and the zona-free hamster test. The role of routine diagnostic laparoscopy and hysteroscopy is also reviewed.

Conclusions. In 2010, the simplicity of the current evaluation of couples presenting with infertility is essential information for patients to know at the initial visit. Ideally, it can help alleviate anxiety and provide patients with a road-map during a visit that is often associated with stress and high emotions.

Target Audience: Obstetricians & Gynecologists, Family Physicians.

Learning Objectives: After completion of this educational activity, the obstetrician/gynecologist should be better able to assess the current recommendations for evaluating infertile couples; examine the various ways to assess ovarian reserve, the uterine cavity, and fallopian patency; and appraise the controversy surrounding diagnostic surgery.

*Assistant Professor; †Fellow, ‡Professor, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL

Chief Editor's Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA Category 1 Credits™ can be earned in 2011. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

The authors, faculty and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.

Authors Jennifer E. Hirshfeld-Cytron and Mary Ellen Pavone contributed equally to this paper.

Correspondence requests to: Mary Ellen Pavone, MD, Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, 676 N. St Clair, Suite 1845, Chicago, Il 60611. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.