Thursday 24 August 2006
Unexplained infertility diagnosis should be dropped
Source:
Human Reproduction 2006; 21: 1951-5
A team of experts argue that unexplained infertility should not be used as a diagnosis for infertility.
US fertility experts have underscored the poor reliability of a diagnosis of unexplained infertility and recommend that it be abandoned.
"So-called unexplained infertility, not only didactically, but, even more importantly, clinically, appears unsustainable as an independent diagnosis," they claim.
In the debating article, N. Gleicher and D. Barad from the Center for Human Reproduction in New York point out the subjective nature of the diagnosis. It depends on which diagnostic tests have been performed, which have not, and to what level of quality. "Paradoxically, a diagnosis of unexplained infertility will, therefore, be more often reached if the diagnostic workup is incomplete or of poor quality," they assert.
Also, the label of unexplained infertility is often a misdiagnosis of other recognized problems, they claim. For instance, the patient may have a non-visible or microscopic precursor stage of endometriosis, or tubal infertility that has been missed by hysterosalpingography, the accuracy of which is notoriously poor. Alternatively, they may be infertile due to premature ovarian aging or immunological infertility.
"Because of the obvious unreliability of a diagnosis of unexplained infertility and the widely reported unevenness in diagnostic criteria, we recommend the abandonment of unexplained infertility as a formal infertility diagnosis," say Gleicher and Barad.
"Diagnostic terminology should be based on evidentiary diagnostic findings and not on their absence."
Posted: 23 August 2006
http://www.orgyn.com/en/news/2006/We...89530810416667
Unexplained infertility diagnosis should be dropped 
