Management of Infertility

BMJ 2007;335:608-11 AH Balen and AJ Rutherford

This BMJ review of fertility opens with intriguing figures that seem worth recalling for primary care fertility discussions:
"For women up to 25 the cumulative conception rate is 60% at 6 months and 85% at a year, but conception rates are more than halved by 35 or over"
Furthermore the point is made that the risk of congenital abnormalities increases with age.

These are patient education points that could usefully be included in contraceptive pill checks.

Ovarian reserve may be assessed with FSH measurement in the first 3 days of the cycle - other tests can supplement this but the validity of using these tests for making long term predictions about fertility is uncertain.