Evaluation and management of infertility in women: The internists' role

Interventions for infertility have greatly increased in number and sophisti cation. Women with multiple medical problems and women near or beyond menop ause are now able to conceive. The internist will be called on to assess th e risk that infertility interventions pose and to counsel patients accordin gly. Knowledge of the medical illnesses associated with infertility, the ty pes of infertility treatments available, and the medical complications of t hese interventions a re required to properly assess th is risk, Medical com plications of infertility interventions can be direct effects of related dr ugs and technologies and indirect consequences of the induced pregnancy, mu ltiple gestation, or associated medical conditions. This article reviews th e definitions and scope of infertility, the interventions used for treatmen t of infertility, the medical complications of these interventions, the pot ential risks of fertility treatment in women unable to conceive spontaneous ly, and important issues for preconception counseling.