Adolescent infertility--to treat or not to treat.
OBJECTIVE
To present the set of reasons for and against fertility treatment for a very young patient.


METHODS
An expert opinion based on clinical experience.


METHODS
An academic-affiliated fertility clinic situated in East Jerusalem.


METHODS
A 16-year-old married teenager with 2 years' duration of infertility due to polycystic ovarian syndrome was referred to our infertility center after treatment with six cycles of clomiphene citrate and ovarian drilling.


METHODS
Counseling of the options of fertility treatments, weight reduction, physical exercise, metformin intake, and an additional gonadotropins-intrauterine insemination cycle with IVF backup.


METHODS
Successful pregnancy while avoiding the risk of ovarian hyperstimulation syndrome.


RESULTS
The patient conceived a single embryo and on the 30th week of gestation suffered premature uterine contractions and gave birth to a 1,330-g preterm male newborn.


CONCLUSIONS
Adolescent contraception and unintended pregnancies are prevalent issues in the Western world, whereas adolescent infertility is unheard of. Early age of marriage and conception imposes tremendous dilemma to the society of reproductive endocrinologists. This important cultural issue ought to be debated regarding the age at marriage, the age at first pregnancy, and the treatment of infertility in married "minors" who need treatment. Such a debate is likely to encourage development of formal guidelines for practitioners, which would clearly be beneficial.
Haimov-Kochman
Ronit
R
Department of Obstetrics and Gynecology, IVF Unit, Hadassah Hebrew University Medical Center, Mt. Scopus, Jerusalem, Israel. kochman@hadassah.org.i
Imbar
Tal
T
Farchat
Murshid
M
Bdolah
Yuval
Y
Hurwitz
Arye
A
D000293:Adolescent; D016497:Adolescent Health Services / Q000941:ethics / Q000331:legislation & jurisprudence; D000367:Age Factors; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro / Q000941:ethics / Q000331:legislation & jurisprudence; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D050498:Live Birth; D008297:Male; D018579:Patient Selection / Q000941:ethics; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000628:therapy; D011247:Pregnancy; D047928:Premature Birth; D016896:Treatment Outcome