UPDATE ON FERTILITY

Advances That are Changing Patient Care

Cryopreservation impact will rival the Pill Breakthroughs in genetic diagnosis Does ART insurance reduce multiple births?

Dr. Randolph is professor and director, division of reproductive endocrinology, department of obstetrics and gynecology, University of Michigan, Ann Arbor, Mich.

Advancements during the year 2003 propelled infertility therapy further than ever along its 20-year evolution toward extensive use of assisted reproductive technologies (ART) and the introduction of diagnostic genetics. Refreshingly, social and ethical implications were viewed with greater recognition that we must deal effectively with the repercussions of technical progress.

Basic evaluation still key; early referral appropriate. For the practicing Ob/Gyn already confused by the bewildering and growing array of options presented to patients, these changes do not mean that a basic infertility evaluation and primary therapy are inappropriate. However, early referral to a trusted, experienced infertility specialist before invasive diagnostic studies such as laparoscopy or aggressive therapies is now most appropriate.