How successful is infertility treatment?

The purpose of this review is to examine whether the time has come to replace clomiphene citrate (CC) as the first line therapy for WHO group II (eu-oestrogenic) infertility, the majority of which is associated with polycystic ovary syndrome. CC has been the first line therapy for these cases for the last 40 years. It is a simple, cheap treatment, almost devoid of side effects which yields a single live birth rate of approximately 25% of starters. Non-response to CC and the gap between ovulation and pregnancy rates have variously been attributed to its anti-estrogen effects, and high LH and androgen concentrations. Three possible contenders for the replacement of CC as first-line treatment are scrutinized: metformin, aromatase inhibitors and low-dose FSH. Each has their advantages and disadvantages, but none of them, while showing much potential promise, has been proven, as yet, to be a feasible replacement for CC in this role. For CC, it may not yet be the end of an era but it may be the beginning of the end.

Please click on the required question.

• 1 How successful is infertility treatment?
• 2 How can we compare infertility treatments?
• 3 How can we compare outcomes between different fertility units?
• 4 Are treatments for infertility improving?
• 5 Is there an increased chance of miscarriage following infertility treatment?
• 6 Is there an increased chance of ectopic pregnancy following infertility treatment?
• 7 What is a heterotopic pregnancy?
• 8 What problems can occur with multiple pregnancy?
• 9 What is selective termination of pregnancy?
• 10 How can the pregnancy risks following infertility treatment be reduced?
• 11 We have had infertility treatment which has been successful. How will our pregnancy be cared for?
• 12 If we have infertility treatment, will our baby be healthy?
• 13 What are the psychological effects of infertility? information?
• 14 Where can I obtain more information?
• 15 Infertility Support Groups.
  

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.