A primary care approach to the infertile couple.
BACKGROUND
Approximately 20% of reproductive age couples have difficulty conceiving or maintaining an established pregnancy. The family physician is in a unique position to provide patient education, begin initial evaluation, make appropriate referrals, and offer ongoing counseling and support to couples who experience problems with fertility.


METHODS
And extensive clinical review was conducted based on a MEDLINE search, the Cochrane database of systematic reviews, and other supporting evidence.


RESULTS
Major physiologic influences affecting live birth rates include age, coital frequency, and duration of infertility. Male factor is associated with approximately 40% of these cases and should be addressed early in the evaluation.


CONCLUSIONS
Many conditions once considered untreatable can now be routinely corrected. As managed care programs expand coverage to include infertility services, primary care providers will be asked to participate in the initial phase of this care. This article offers a practical approach.
Whitman-Elia
G F
GF
Department of Obstetrics and Gynecology, University of South Carolina School of Medicine, Columbia 29203, USA.
Baxley
E G
EG
D000026:Abortion, Habitual; D000328:Adult; D003376:Counseling; D006233:Persons with Disabilities / Q000331:legislation & jurisprudence; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D007246:Infertility / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007348:Insurance, Health; D008297:Male; D008487:Medical History Taking; D010808:Physical Examination; D011320:Primary Health Care / Q000379:methods*