Medical Policy in Vitro Fertilization (IVF) and Other Fertility Services CT

Total Page:16

File Type:pdf, Size:1020Kb

Medical Policy in Vitro Fertilization (IVF) and Other Fertility Services CT Medical Policy In Vitro Fertilization (IVF) and Other Fertility Services CT Subject: In Vitro Fertilization (IVF) and Other Fertility Services CT Contents Background: ............................................................................................................................................................ 2 Prior Authorization: .................................................................................................................................................. 2 Authorization of Preimplantation Genetic Diagnosis (PGD) ....................................................................................... 3 POLICY AND COVERAGE CRITERIA FOR MEMBERS WITH UTERI/EGGS: ........................................................ 3 General eligibility criteria for Members with Uteri/Eggs ................................................................................................ 4 Ib. Assessment of ovary/uterus function: ........................................................................................................... 4 Ic. Assessment of contributory testicles/sperm: .................................................................................................. 4 II. Intrauterine Insemination (IUI) ........................................................................................................................ 5 IIa. Initiation to IUI ......................................................................................................................................... 5 IIb. Continuing IUI ........................................................................................................................................... 5 IIc. IUI after in vitro fertilization ........................................................................................................................ 5 IId. Conversion to IVF from IUI with hyper-response .......................................................................................... 5 III. Fertility services ............................................................................................................................................. 6 IIIa. In Vitro Fertilization (IVF) services ............................................................................................................. 6 In vitro fertilization service-specific criteria ..................................................................................................... 6 Cycle specifications and limitations ................................................................................................................ 6 Delivery protocols .................................................................................................................................... 6 Repeat cycle documentation ..................................................................................................................... 6 Service maximum ..................................................................................................................................... 6 Gamete and Zygote Intrafallopian Transfer (GIFT & ZIFT) ............................................................................... 6 IIIb. Donor egg (donor oocyte) ......................................................................................................................... 7 IIIc. Assisted Hatching (AH) .............................................................................................................................. 7 IIId. Reversal of prior sterilization ..................................................................................................................... 7 IIIe. Oocyte stimulation, retrieval, and fertilization .............................................................................................. 8 IIIf. Intracytoplasmic Sperm Injection (ICSI) ...................................................................................................... 8 IV. Cryopreservation of eggs and/or embryos ......................................................................................................... 8 IVa. Cryopreservation of eggs or sperm (including retrieval and up to one year of storage) for a member in active (authorized) fertility treatment: ......................................................................................................................... 8 IVb. Cryopreservation of eggs or sperm (including retrieval and up to one year of storage) anticipatory to medical treatment expected to impact fertility: ............................................................................................................... 8 HPHC Medical Policy Page 1 of 15 In Vitro Fertilization (IVF) and Other Fertility Services CT VD29SEP21P HPHC policies are based on medical science, and written to apply to the majority of people with a given condition. Individual members’ unique clinical circumstances, and capabilities of the local delivery system are considered when making individual UM determinations. Coverage described in this policy is standard under most HPHC plans. Specific benefits may vary by product and/or employer group. Please reference appropriate member materials (e.g. Benefit Handbook, Certificate of Coverage) for member-specific benefit information. IVc. Cryopreservation of eggs or sperm (including retrieval and up to one year of storage) for members undergoing gender reassignment treatment: ....................................................................................................................... 9 POLICY AND COVERAGE CRITERIA FOR MEMBERS WITH TESTICLES/SPERM: ............................................... 9 I. Fertility services................................................................................................................................................ 9 Ia. Fertility confirmation requirement ................................................................................................................. 9 Ib. Intracytoplasmic Sperm Injection (ICSI) ....................................................................................................... 9 Ic. Donor sperm ............................................................................................................................................ 10 Id. Microsurgical Epididymal Sperm Aspiration (MESA) ...................................................................................... 10 Ie. Testicular Sperm Extraction (TESE) or Micro-TESE ....................................................................................... 10 If. Reversal of prior sterilization ....................................................................................................................... 10 II. Sperm collection and cryopreservation ............................................................................................................ 10 IIa. Cryopreservation related to fertility or medical treatment ............................................................................ 10 IIIb. Cryopreservation of eggs or sperm (including retrieval and up to one year of storage) for members undergoing gender reassignment treatment ...................................................................................................................... 11 Exclusions: ............................................................................................................................................................ 11 Guidelines and benchmarks: ................................................................................................................................... 12 Coding: ................................................................................................................................................................. 13 Billing Guidelines: .................................................................................................................................................. 13 References: ........................................................................................................................................................... 13 Background: This policy addresses fertility treatments and their uses. These services include in vitro fertilization (IVF), intrauterine insemination (IUI), gamete intrafallopian transfer, zygote intrafallopian transfer, tubal embryo transfer, gamete, embryo, and sperm cryopreservation, use of frozen embryos or eggs, oocyte and embryo donation, and gestational surrogacy. Infertility under age 35 is defined as the failure to achieve live birth when fertility would naturally be expected after 12 months or more of regular contraceptive-free sexual intercourse between an individual with ovaries/eggs and an individual with testes/sperm, as represented by the member and documented in the medical record. Infertility over age 35 is defined as the failure to achieve a live birth after 6 months or more of regular contraceptive-free sexual intercourse between an individual with ovaries/eggs and an individual with testes/sperm, as represented by the member and documented in the medical record. In cases where insemination is being used in lieu of intercourse, infertility is defined as the failure to achieve a live birth after 6 months of inseminations, either performed at home or in a supervised medical setting, as represented by the member and documented in the medical record. Fertility services rendered prior to diagnosis of clinical infertility are not covered. Prior Authorization:
Recommended publications
  • Genes in His Jeans] [Molly Kane] James Madison University Lexia Ÿ Volume V Ÿ 2
    Lexia: Undergraduate Journal in Writing, Rhetoric & Technical Communication Volume V 2016–2017 [Genes in his Jeans] [Molly Kane] James Madison University Lexia Volume V 2 If you asked women who were considering sperm donation what their ideal donor was like, you would probably receive answers like “smart,” “kind,” “tall,” and “healthy” (“What Women Want”). They would want their donor to be the perfect man, so that they would have the perfect child. Now imagine someone who you would see going to a clinic to donate their sperm. Is that man a fit and handsome stock broker, right off Wall Street, or is he a poor college student with bad acne looking to make some extra cash? To say the least, sperm donors span all walks of life. Women flip through hundreds of applications when trying to choose which donor will be the father of her child, and only general information is given to her about each donor. It is hard to imagine how one of the biggest decisions of her life will be based off which self-proclaimed personality traits she likes best. One of the greatest concerns when selecting a sperm sample is the state of health of the donor. Every mother wants a healthy baby, and in order for this to happen with donor-conceived children, both the mother and father need to be healthy individuals. You would assume that sperm banks only accept donors with a thorough health history and health risk evaluation, and you would probably also assume that they require tests for life-threatening diseases, such as cystic fibrosis.
    [Show full text]
  • A Study of Bioethical Qualifiers in the Donation of Human Sperm
    Intersect, Vol 14, No 2 (2021) Creating Boundaries in the Sperm Donation Industry: A Study of Bioethical Qualifiers in the Donation of Human Sperm Tanvee Sinha1 1 The University of Alabama at Birmingham While sperm donation has become a common and effective practice amongst many who suffer from the inability to conceive naturally, the practice's bioethical implications may reveal a necessity to place qualifying constrictions on the practice. Some examples of related ethical issues range from psychological impacts on offspring as a result of partial genetic dissociation from parents, and discriminatory practices, such as “shopping” for traits or narrow descriptions of optimal sperm donors. Regulations for eligible donors vary in different regions, while keeping some sort of uniformity through criteria, including height, weight, education, and lifestyle choices. This piece highlights some of the major cultural differences between China and the USA in regard to the regulation of sperm donation. Recently in China, after the “one- child only” policy was lifted, there is an increasing demand for sperm donors now than ever, but with new policies, it is even more difficult to donate and purchase sperm. Due to donors not being able to qualify for the “amount of patriotism” needed, there is an increased use of underground operations, such as the black market. These operations are often unsafe and have no regulation, encouraged by donors and middlemen solely seeking monetary value. Sinha, Boundaries in Sperm Donation Background In the twentieth century, there has been a rapid advancement in technology, causing numerous innovative ways for one to now have a child.
    [Show full text]
  • Infertility Update
    Infertility Update George R Attia, M.D Director of IVF Program University of Texas Southwestern Medical Center at Dallas Infertility • Inability to conceive after one year of adequate unprotected intercourse (six months if the woman is over age 35) Time Required for Conception in Couples Who Will Attain Pregnancy 100 93 95 90 85 80 72 70 nt 57 60 na g 45 e 50 r P 40 % 30 25 20 10 0 1 month 2 months 3 months 6 months 1 Year 2 Year 3 ear 7% 3% 35% Male Factor 20% Tubal Factor Ov dysfunction Unexplained Others 35% 10% 10% 40% Anovulatory Tubal & Pelvic Unusual factors Unexplained 40% • Anovulation • Tubal Factor • Male • Pelvic Factor (Endometriosis, adhesion) • Unexplained • Uterine/cervical (fibroid) 10% PCOS Others 90% Ovulation • History •BBT • LH kits • Mid luteal phase Progesterone (cycle length –7) • Ultrasound • EMB (day 21-26) • Anovulation • Tubal / Pelvic Factor • Male • Unexplained • Uterine/cervical (fibroid) Tubal & Pelvic Factors • Tubal disease, PID • Tubal surgery • Pelvic adhesions • Endometriosis Tubal Factor • Tubal infertility after PID (12%, 24%, 50%) • One-half of patients who found to have tubal damage and/or pelvic adhesion have no history of antecedent disease Tubal Factor • Hysterosalpingography • Hysteroscopy / laparoscopy • Falloscopy • Anovulation • Tubal Factor • Male • Unexplained • Uterine/cervical (fibroid) Male Factor Infertility • Anatomic defects (hypospadias, Retrograde ejac.) • Genetics Causes • Trauma • Infection • Endocrine disorders •Varicocele Male Factor Infertility • Vol. > 2 ml, Conc. > 20x106,
    [Show full text]
  • Male Infertility
    www.livestrong.org.livestrong.org Male Infertility Some male cancer survivors find that they are not able to have children due to the effects of cancer treatment. By identifying your risk for infertility, you can take steps before treatment to preserve your fertility. For survivors who have already completed treatment, there are other options for having children. Male Infertility: Detailed Information This infinformationormation is meant to be a general introduction to this topic. The purpose is to provide a starting point for you to become more informed about important matters that may be affecting your life as a survivor and to provide ideas about steps you can take to learn more. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Suggestions (http://www.livestrong.org/Get-Help/Learn-About-Cancer/Cancer-Support-Topics/Physical-Effects-of- Cancer/Male-Infertility#a#a) and Additional Resources (http://www.livestrong.org/Get-Help/Learn- About-Cancer/Cancer-Support-Topics/Physical-Effects-of-Cancer/Male-Infertility#a#a) sections for questions to ask and for more resources. Cancer and treatment may put survivors at risk for infertility. Male infertility generally means an inability to produce healthy sperm or to ejaculate sperm. There are many different causes of infertility in cancer survivors including physical and emotional. Certain treatments can cause or contribute to this condition. It is best to discuss the risks of infertility with your doctor before cancer treatment begins. However, there are options for survivors who experience infertility as a result of cancer or treatment.
    [Show full text]
  • Polycystic Ovary Syndrome, Oligomenorrhea, and Risk of Ovarian Cancer Histotypes: Evidence from the Ovarian Cancer Association Consortium
    Published OnlineFirst November 15, 2017; DOI: 10.1158/1055-9965.EPI-17-0655 Research Article Cancer Epidemiology, Biomarkers Polycystic Ovary Syndrome, Oligomenorrhea, and & Prevention Risk of Ovarian Cancer Histotypes: Evidence from the Ovarian Cancer Association Consortium Holly R. Harris1, Ana Babic2, Penelope M. Webb3,4, Christina M. Nagle3, Susan J. Jordan3,5, on behalf of the Australian Ovarian Cancer Study Group4; Harvey A. Risch6, Mary Anne Rossing1,7, Jennifer A. Doherty8, Marc T.Goodman9,10, Francesmary Modugno11, Roberta B. Ness12, Kirsten B. Moysich13, Susanne K. Kjær14,15, Estrid Høgdall14,16, Allan Jensen14, Joellen M. Schildkraut17, Andrew Berchuck18, Daniel W. Cramer19,20, Elisa V. Bandera21, Nicolas Wentzensen22, Joanne Kotsopoulos23, Steven A. Narod23, † Catherine M. Phelan24, , John R. McLaughlin25, Hoda Anton-Culver26, Argyrios Ziogas26, Celeste L. Pearce27,28, Anna H. Wu28, and Kathryn L. Terry19,20, on behalf of the Ovarian Cancer Association Consortium Abstract Background: Polycystic ovary syndrome (PCOS), and one of its cancer was also observed among women who reported irregular distinguishing characteristics, oligomenorrhea, have both been menstrual cycles compared with women with regular cycles (OR ¼ associated with ovarian cancer risk in some but not all studies. 0.83; 95% CI ¼ 0.76–0.89). No significant association was However, these associations have been rarely examined by observed between self-reported PCOS and invasive ovarian cancer ovarian cancer histotypes, which may explain the lack of clear risk (OR ¼ 0.87; 95% CI ¼ 0.65–1.15). There was a decreased risk associations reported in previous studies. of all individual invasive histotypes for women with menstrual Methods: We analyzed data from 14 case–control studies cycle length >35 days, but no association with serous borderline including 16,594 women with invasive ovarian cancer (n ¼ tumors (Pheterogeneity ¼ 0.006).
    [Show full text]
  • The Acrosomal Status of Density Purified Spermatozoa Differentiates
    Journal of Clinical Medicine Article The Acrosomal Status of Density Purified Spermatozoa Differentiates Men from Couples in IVF and ICSI Treatment and Is Associated with Fecundity 1,2, 3, 4 Pernille Badsberg Norup y, Dorte L. Egeberg Palme y, Morten R. Petersen , Katharina M. Main 1,2 and Kristian Almstrup 1,2,* 1 Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; [email protected] (P.B.N.); [email protected] (K.M.M.) 2 International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark 3 European Sperm Bank ApS, DK-2200 Copenhagen, Denmark; [email protected] 4 The Fertility Clinic, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; [email protected] * Correspondence: [email protected]; Tel.: +45-35-45-66-39 The authors consider that the first two authors should be regarded as joint First Authors. y Received: 26 June 2020; Accepted: 20 July 2020; Published: 22 July 2020 Abstract: The acrosome of the spermatozoa is required for fertilization and in the raw ejaculate the percentage of viable acrosome-intact spermatozoa, the acrosomal status, is higher among men with good semen quality. Here we investigated if the acrosomal status of the processed semen preparations used at a fertility clinic can also be informative and whether it is associated with fecundity. The acrosomal status was measured by image cytometry on purified semen samples from couples during in vitro fertilization (IVF) (n = 99) and intracytoplasmic sperm injection (ICSI) (n = 107) treatment.
    [Show full text]
  • Risk of First Trimester Spontaneous Miscarriage Among Singleton
    Middle East Fertility Society Journal (2013) xxx, xxx–xxx Middle East Fertility Society Middle East Fertility Society Journal www.mefsjournal.org www.sciencedirect.com ORIGINAL ARTICLE Risk of first trimester spontaneous miscarriage among singleton gestations following ICSI and its relation to underlying cause of infertility Wessam Magdi Abuelghar a,*, Osama Saleh Elkady a, Tarek Fathi. Tamara a, Mona Hassan Khalil b a Obstetrics and Gynaecology Department, Ain-shams University, Cairo, Egypt b Obstetrics and Gynaecology Department, El Khazendara MOH Hospital, Cairo, Egypt Received 16 April 2013; accepted 12 June 2013 KEYWORDS Abstract Study objective: To assess the association between the first trimester miscarriage rates Miscarriage; among women undergoing intracytoplasmic sperm injection (ICSI) and underlying etiology of ICSI; infertility. Infertility Design: Prospective cohort study. Setting: Ain Shams University maternity hospital. Materials and methods: The study included women who became pregnant with singleton preg- nancy following ICSI as a treatment for different causes of infertility. Women were followed up throughout the first trimester of pregnancy up to 12 weeks’ gestation (10 weeks after the day of embryo transfer). Main outcome measure: First trimester miscarriage rate. Results: Two hundred and thirty four pregnant young women were included in the study, 164 (70.9%) women miscarried. The causes of infertility among these women were as follows: 41 (25%) mild male factor infertility, 40 (24.4%) severe male factor infertility, 45 (27.44%) tubal fac- tor, 7 (4.27%) polycystic ovarian syndrome, 3 (1.83%) endometriosis, 20 (12.19%) unexplained and Abbreviations: BMI, body mass index; CI, confidence interval; E2, estradiol; ET, embryo transfer; FSH, follicle stimulating hormone; GnRH, gonadotropin-releasing hormone; hCG, human chorionic gonadotropin; ICSI, intracytoplasmic sperm injection; IVF, in vitro fertilization; LH, luteinizing hormone; LMP, last menstrual period; OR, odds ratio; SD, standard deviation * Corresponding author.
    [Show full text]
  • Donor INSEMINATION Insemination
    CLiInSemBrochure_CryoGenicInSemBrochure 12/14/10 12:28 PM Page 1 DONOR Donor INSEMINATION Insemination Donor insemination (DI) is a simple procedure that uses a syringe to place sperm into a woman’s vagina or uterus to assist her in becoming pregnant. The sperm is obtained from someone other than a woman’s husband or partner. Sperm banks (also known as cryobanks) offer a selection of screened and tested sperm donors for those interested in using DI. Your physician will discuss which DI procedure is right for you. There are basically two types of insemination options: intrauterine or intracervical. • INTRAUTERINE INSEMINATION: Semen is inserted directly into the uterus, by way of the cervical opening, using a small catheter. The sperm specimen is labeled as IUI (intrauterine) and is pre-washed, meaning that seminal plasma is removed prior to freezing. • INTRACERVICAL INSEMINATION: Semen is placed into the cervical opening. Sperm is typically labeled as ICI (intracervical or standard) and is unwashed, i.e. the seminal plasma has not been removed. WHY CHOOSE DI? There are several advantages to using DI over other methods: • Donor selection can be made with the participation of your husband or partner. • The woman can experience pregnancy and all the excite - ment, anticipation and bonding derived from carrying and delivering her child. This brochure is the courtesy of • As a mother, you will know that your child is produced from your own eggs and your own genetic material. Donor Insemination (DI) is widely • By attending the inseminations, the husband or partner can practiced throughout the world with an share in the child’s conception.
    [Show full text]
  • Race and Assisted Reproduction: Implications for Population Health
    RACE AND ASSISTED REPRODUCTION: IMPLICATIONS FOR POPULATION HEALTH Aziza Ahmed* INTRODUCTION This Article emerges from Fordham Law Review’s Symposium on the fiftieth anniversary of Loving v. Virginia,1 the case that found antimiscegenation laws unconstitutional.2 Inspired by the need to interrogate the regulation of race in the context of family, this Article examines the diffuse regulatory environment around assisted reproductive technology (ART) that shapes procreative decisions and the inequalities that these decisions may engender.3 ART both centers biology and raises questions about how we imagine our racial futures in the context of family, community, and nation.4 Importantly, ART demonstrates how both the state and private * Professor of Law, Northeastern University School of Law. Many thanks to Kimani Paul- Emile, Robin Lenhardt, and Tanya Hernández for inviting me to participate in the Fordham Law Review Symposium entitled Fifty Years of Loving v. Virginia and the Continued Pursuit of Racial Equality held at Fordham University School of Law on November 2–3, 2017. My deep gratitude to Melissa Murray, Jason Jackson, and Libby Adler for their generous comments on an earlier draft of this Article and to Linda McClain and Ashley Shattles for several helpful discussions that helped shape this paper. For an overview of the Symposium, see R.A. Lenhardt, Tanya K. Hernández & Kimani Paul-Emile, Foreword: Fifty Years of Loving v. Virginia and the Continued Pursuit of Racial Equality, 86 FORDHAM L. REV. 2625 (2018). 1. 388 U.S. 1 (1967). 2. Id. at 11–12. 3. Another site of racial regulation in the context of family formation that is not discussed in this Article is adoption.
    [Show full text]
  • Artificial Insemination
    Ch36-A03309.qxd 1/23/07 5:16 PM Page 539 Section 6 Infertility and Recurrent Pregnancy Loss Chapter Artificial Insemination 36 Ashok Agarwal and Shyam S. R. Allamaneni INTRODUCTION widely available, the terms homologous artificial insemination and heterologous artificial insemination were used to differentiate Artificial insemination is an assisted conception method that can these two alternative sources. However, the use of these bio- be used to alleviate infertility in selected couples. The rationale medical terms in this manner is at variance with their scientific behind the use of artificial insemination is to increase the gamete meaning, where they denote different species or organisms (as in, density near the site of fertilization.1 The effectiveness of artificial e.g., homologous and heterologous tissue grafts). insemination has been clearly established in specific subsets of In the latter half of the 20th century, the terms artificial infertile patients such as those with idiopathic infertility, infertility insemination, donor (AID) and artificial insemination, husband related to a cervical factor, or a mild male factor infertility (AIH) found common use. However, the widespread use of the (Table 36-1).2,3 An accepted advantage of artificial insemination acronym AIDS for acquired immunodeficiency syndrome resulted is that it is generally less expensive and invasive than other in the replacement of AID with therapeutic donor insemination assisted reproductive technology (ART) procedures.4 (TDI). An analogous alternative term for AIH has not evolved, This chapter provides a comprehensive description of probably in part because of the increasingly common situation indications for artificial insemination, issues to consider before where the woman’s partner is not her legal husband.
    [Show full text]
  • Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009†
    Human Reproduction, Vol.24, No.11 pp. 2683–2687, 2009 Advanced Access publication on October 4, 2009 doi:10.1093/humrep/dep343 SIMULTANEOUS PUBLICATION Infertility The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009† F. Zegers-Hochschild1,9, G.D. Adamson2, J. de Mouzon3, O. Ishihara4, R. Mansour5, K. Nygren6, E. Sullivan7, and S. van der Poel8 on behalf of ICMART and WHO 1Unit of Reproductive Medicine, Clinicas las Condes, Santiago, Chile 2Fertility Physicians of Northern California, Palo Alto and San Jose, California, USA 3INSERM U822, Hoˆpital de Biceˆtre, Le Kremlin Biceˆtre Cedex, Paris, France 4Saitama Medical University Hospital, Moroyama, Saitana 350-0495, JAPAN 53 Rd 161 Maadi, Cairo 11431, Egypt 6IVF Unit, Sophiahemmet Hospital, Stockholm, Sweden 7Perinatal and Reproductive Epidemiology and Research Unit, School Women’s and Children’s Health, University of New South Wales, Sydney, Australia 8Department of Reproductive Health and Research, and the Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland 9Correspondence address: Unit of Reproductive Medicine, Clinica las Condes, Lo Fontecilla, 441, Santiago, Chile. Fax: 56-2-6108167, E-mail: [email protected] background: Many definitions used in medically assisted reproduction (MAR) vary in different settings, making it difficult to standardize and compare procedures in different countries and regions. With the expansion of infertility interventions worldwide, including lower resource settings, the importance and value of a common nomenclature is critical. The objective is to develop an internationally accepted and continually updated set of definitions, which would be utilized to standardize and harmonize international data collection, and to assist in monitoring the availability, efficacy, and safety of assisted reproductive technology (ART) being practiced worldwide.
    [Show full text]
  • Diagnostic Evaluation of the Infertile Female: a Committee Opinion
    Diagnostic evaluation of the infertile female: a committee opinion Practice Committee of the American Society for Reproductive Medicine American Society for Reproductive Medicine, Birmingham, Alabama Diagnostic evaluation for infertility in women should be conducted in a systematic, expeditious, and cost-effective manner to identify all relevant factors with initial emphasis on the least invasive methods for detection of the most common causes of infertility. The purpose of this committee opinion is to provide a critical review of the current methods and procedures for the evaluation of the infertile female, and it replaces the document of the same name, last published in 2012 (Fertil Steril 2012;98:302–7). (Fertil SterilÒ 2015;103:e44–50. Ó2015 by American Society for Reproductive Medicine.) Key Words: Infertility, oocyte, ovarian reserve, unexplained, conception Use your smartphone to scan this QR code Earn online CME credit related to this document at www.asrm.org/elearn and connect to the discussion forum for Discuss: You can discuss this article with its authors and with other ASRM members at http:// this article now.* fertstertforum.com/asrmpraccom-diagnostic-evaluation-infertile-female/ * Download a free QR code scanner by searching for “QR scanner” in your smartphone’s app store or app marketplace. diagnostic evaluation for infer- of the male partner are described in a Pregnancy history (gravidity, parity, tility is indicated for women separate document (5). Women who pregnancy outcome, and associated A who fail to achieve a successful are planning to attempt pregnancy via complications) pregnancy after 12 months or more of insemination with sperm from a known Previous methods of contraception regular unprotected intercourse (1).
    [Show full text]