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Trends in causes and treatment of infertility at Flinders Medical Centre, Adelaide, 1976–1989
Author(s) -
Weiss Timothy J,
Meffin Elaine M,
Jones Robert G,
Jones Warren R
Publication year - 1992
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1992.tb139783.x
Subject(s) - medicine , infertility , fertility , endometriosis , gamete intrafallopian transfer , gynecology , fertility clinic , obstetrics , incidence (geometry) , unexplained infertility , pregnancy , population , genetics , physics , environmental health , optics , biology
Objective: To describe the causes of infertility among couples presenting to a fertility clinic over a period of 14 years. Changes in treatment methods over the same period are described. Design: A retrospective analysis of records of patient age, date of first visit, duration and cause of infertility, treatment and outcome. Setting: A fertility clinic set in a large public hospital. Patients are referred by both general gynaecologists and general practitioners. Patients: From 1976 to 1989 (inclusive) 2895 couples who had engaged in unprotected intercourse for at least 12 months without conceiving attended the clinic. Results: Three major diagnostic categories were considered; these embraced aetiolog‐ ical factors relating to semen, ovulation, and pelvic anatomy. Investigation of the causes of infertility after a couple's first visit showed these to be a semen defect in 22%, irregular cycles or anovulation in 29%, and a pelvic disorder in 57%. The incidence of semen defects as the cause remained constant between 1976 and 1989 while that of ovulation “problems” declined from 42% in 1976 to 13% in 1989. In contrast, the incidence of pelvic dysfunction increased from 40% in 1976 to 68% in 1989, predominantly due to an increased diagnosis of endometriosis. The principal treatments were ovulation induction/cycle regulation (51%), in‐vitro fertilisation/gamete intrafallopian transfer (42%), and donor insemination (18%). Conclusions: Provided patient information is accurately and consistently recorded a Fertility Audit is a useful window on the activities of a Fertility Clinic and serves to highlight areas which warrant further investigation.