title: Should IVF be used as first-line treatment or as a last resort? A debate presented at the 2013 Canadian Fertility and Andrology Society meeting.
abstract: Infertility outcomes can be influenced by many factors. Although a number of treatments are offered, deciding which one to use first is a controversial topic. Although IVF may have superior efficacy in achieving a live birth with a reasonable safety profile, the availability of cheaper and less invasive treatments preclude its absolute use. For this reason, certain patient groups with 'good-prognosis' infertility are traditionally treated with less invasive treatments first. 'Good-prognosis' infertility may include unexplained infertility, mild male factor infertility, stage I or II endometriosis, unilateral tubal blockage and diminished ovarian reserve. Here, evidence behind the use of IVF as a first-line treatment is compared with its use as a last-resort option in women with 'good-prognosis' infertility.
authors.affiliation: Department of Obstetrics and Gynecology, McGill University, 687 Pine Ave West, Montreal, Quebec, H3A 1A1, Canada.
authors.forename: Lina N
authors.initials: LN
authors.lastname: Huang
authors.affiliation: McGill Medical School, McIntyre Medical Building, 3655 Sir William Osler, Montreal, Quebec, H3G 1Y6, Canada.
authors.forename: Justin
authors.initials: J
authors.lastname: Tan
authors.affiliation: Olive Fertility Centre, Suite 300, East Tower, 555 West 12th Avenue, Vancouver, British Columbia, V5Z 3X7, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Hitkari
authors.affiliation: Department of Obstetrics and Gynecology, McGill University, 687 Pine Ave West, Montreal, Quebec, H3A 1A1, Canada. Electronic address: dahanhaim@hotmail.com.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Dahan
mesh_terms: D002170:Canada; D004715:Endometriosis / Q000628:therapy; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics / Q000379:methods* / Q000639:trends; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007247:Infertility, Female / Q000628:therapy; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D065851:Ovarian Reserve; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011379:Prognosis; D027724:Reproductive Techniques, Assisted / Q000191:economics / Q000639:trends; D012955:Societies, Medical
keywords: assisted reproductive treatment; first line; in-vitro fertilization; ovarian stimulation