Advances in infertility.

Recent advances in the diagnosis and treatment of infertility, including in vitro fertilization, the use of danazol for endometriosis, and the availability of bromocriptine for the galactorrhea-amenorrhea syndrome, are described. The most common sequence for infertility work-up is: 1) evaluation of basal body temperature, 2) postcoital testing, 3) semen analysis, 4) endometrial biopsy, 5) hystersalpingography and Rubin's test, and 6) endoscopy. When this type of organized investigation reveals the causal factors responsible for infertility, therapy can be instituted. Treatment can focus around ovulatory disorders, cervical problems, male factors, luteal phase defects, tubal factors, uterine factors, or endometriosis. Objective comparison of the various treatments through the establishment of standardized classifications and organized regimens is important to future fertility investigation. A problem in comparing the pregnancy rates of treatments has been the variability in length of follow-up. This difficulty has been largely overcome by the method for calculating the "expectancy" of pregnancy with an assumption of indefinite follow-up.