Volume 26, Issue 7, July 2016, Pages 210–215
Case-based learning
- Mamoun Bereir MD MRCPI is a Clinical Fellow in Reproductive Medicine at Rotunda IVF, Rotunda Hospital, Dublin, Ireland. Conflicts of interest: none declared
- Carol Coughlan FRCOG FRCPI MD is a Subspecialist in Reproductive Medicine and Surgery at Rotunda IVF, Rotunda Hospital, Dublin, Ireland. Conflicts of interest: none declared
- Available online 3 June 2016
Abstract
Subfertile
couples by definition require medical help to get pregnant after trying
unsuccessfully for a variable period of time. Although the term
subfertility is also occasionally used in the context of women who can
conceive, but suffer recurrent miscarriages, this broad aspect is
outside the scope of this chapter. Subfertility can seriously affect
mental and social well-being, although not generally viewed as a disease
that significantly causes physical ill health. On the contrary,
subfertility may in fact be the early manifestation of serious
co-existing disease. Advances in assisted reproductive technology in the
last 25 years have simplified and diversified treatment options,
thereby rendering the terms infertility and sterility unfashionable. As a
result, there is now an unfortunate trend for couples to be subjected
to superficial medical history and only perfunctory physical
examinations, occasionally missing the presentations and implications of
associated co-morbidities, with devastating implications. There are now
many guidelines on the initial investigations and subsequent management
of the subfertile couple. It is therefore now relatively easy to assist
a couple to achieve a pregnancy. However, dealing with the devastating
news of causative factors like azoospermia, genetic disease, congenital
anomaly or premature ovarian failure can be very difficult. To discuss
these sympathetically, professionals require interpersonal skills in
breaking bad news. Finally, a multidisciplinary team approach should be
adopted to cater for the long-term health consequences, whenever
co-morbidities are detected.
Keywords
- anovulation;
- azoospermia;
- fallopian tube diseases;
- hydrosalpinx;
- infertility;
- IVF;
- oligospermia;
- PCOS
© 2016 Published by Elsevier Ltd.
