What the internist needs to know about infertility

Primary care physicians can manage two thirds of cases of suspected infertility. Assisted reproductive technology can help in many cases of pelvic adhesive disease, although the effectiveness of these procedures declines significantly with patient age. Testing for ovarian reserve is an important first step for many patients who are considering infertility treatment. Some causes of infertility are associated with significant medical problems such as diabetes and abnormal lipids; these should be assessed and a long-term management plan implemented.