Assisted reproductive technology in the new millennium: part I

Abstract

Infertility has been clinically defined as the inability to conceive after 1 year of unprotected and regular sexual intercourse. In the United States today, approximately 13% of married couples are infertile, representing approximately 5 million couples.1 Most infertile couples have never had children and therefore have primary infertility. A smaller number of couples with secondary infertility have been able to initiate conception in the past and then had difficulty. Current recommendations support initiating an infertility evaluation after the completion of at least 1 year of regular, unprotected sexual intercourse, unless a known risk factor for infertility exists. In the past, treatment options were limited to assist only those couples in whom a reversible cause of infertility could be identified, such as obstructive azoospermia, tubal obstruction, and varicoceles.2 Couples without a correctable abnormality were offered empirical therapies that were largely ineffective or the options of donor insemination and adoption. With the advent of new technological breakthroughs during the past decade, many patients who were previously labeled as sterile have newfound hope. Significant advances in assisted reproductive technology provide these couples with exciting new and effective treatment options.