What the internist needs to know about infertility

Primary care physicians can manage two thirds of cases of suspected inferti lity. Assisted reproductive technology can help in many cases of pelvic adh esive disease, although the effectiveness of these procedures declines sign ificantly with patient age. Testing for ovarian reserve is an important fir st step for many patients who are considering infertility treatment. Some c auses of infertility are associated with significant medical problems such as diabetes and abnormal lipids; these should be assessed and a;long-term m anagement plan implemented.