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Infertility

MedGen UID:
43876
Concept ID:
C0021359
Finding; Pathologic Function
Synonyms: Reproductive Sterility; Sterility; Sterility, Reproductive
SNOMED CT: Sterility (15296000); Infertile (8619003); Difficulty conceiving (8619003); Cannot achieve a pregnancy (8619003)
 
HPO: HP:0000789

Definition

Infertility means not being able to become pregnant after a year of trying. If a woman can get pregnant but keeps having miscarriages or stillbirths, that's also called infertility. Infertility is fairly common. After one year of having unprotected sex, about 15 percent of couples are unable to get pregnant. About a third of the time, infertility can be traced to the woman. In another third of cases, it is because of the man. The rest of the time, it is because of both partners or no cause can be found. There are treatments that are specifically for men or for women. Some involve both partners. Drugs, assisted reproductive technology, and surgery are common treatments. Happily, many couples treated for infertility go on to have babies. NIH: National Institute of Child Health and Human Development.  [from MedlinePlus]

Conditions with this feature

Celiac disease
MedGen UID:
3291
Concept ID:
C0007570
Disease or Syndrome
Celiac disease is a systemic autoimmune disease that can be associated with gastrointestinal findings (diarrhea, weight loss, abdominal pain, anorexia, lactose intolerance, abdominal distention, and irritability) and/or highly variable non-gastrointestinal findings (iron deficiency anemia, dermatitis herpetiformis, chronic fatigue, joint pain/inflammation, migraines, depression, attention-deficit disorder, epilepsy, osteoporosis/osteopenia, infertility and/or recurrent fetal loss, vitamin deficiencies, short stature, failure to thrive, delayed puberty, dental enamel defects, and autoimmune disorders). Classic celiac disease, characterized by mild to severe gastrointestinal symptoms, is less common than non-classic celiac disease, characterized by absence of gastrointestinal symptoms.
Hyperprolactinemia
MedGen UID:
5698
Concept ID:
C0020514
Disease or Syndrome
Hyperprolactinemia unrelated to pregnancy occurs in approximately 0.1 to 0.3% of the general population and may result in infertility, hypogonadism, and galactorrhea. Such nonphysiologic hyperprolactinemia is caused mainly by drugs or by tumors in the anterior pituitary gland, primarily prolactinomas (see 600634). However, 10 to 60% of patients with hyperprolactinemia who undergo MRI have normal findings (summary by Newey et al., 2013).
Prader-Willi syndrome
MedGen UID:
46057
Concept ID:
C0032897
Congenital Abnormality
Prader-Willi syndrome (PWS) is characterized by severe hypotonia and feeding difficulties in early infancy, followed in later infancy or early childhood by excessive eating and gradual development of morbid obesity (unless eating is externally controlled). Motor milestones and language development are delayed. All individuals have some degree of cognitive impairment. A distinctive behavioral phenotype (with temper tantrums, stubbornness, manipulative behavior, and obsessive-compulsive characteristics) is common. Hypogonadism is present in both males and females and manifests as genital hypoplasia, incomplete pubertal development, and, in most, infertility. Short stature is common (if not treated with growth hormone); characteristic facial features, strabismus, and scoliosis are often present.
Testosterone 17-beta-dehydrogenase deficiency
MedGen UID:
120626
Concept ID:
C0268296
Disease or Syndrome
17-beta hydroxysteroid dehydrogenase 3 deficiency is a condition that affects male sexual development. People with this condition are genetically male, with one X and one Y chromosome in each cell, and they have male gonads (testes). Their bodies, however, do not produce enough of the male sex hormone testosterone. Testosterone has a critical role in male sexual development, and a shortage of this hormone disrupts the formation of the external sex organs before birth.Most people with 17-beta hydroxysteroid dehydrogenase 3 deficiency are born with external genitalia that appear female. In some cases, the external genitalia do not look clearly male or clearly female (sometimes called ambiguous genitalia). Still other affected infants have genitalia that appear predominantly male, often with an unusually small penis (micropenis) or the urethra opening on the underside of the penis (hypospadias).During puberty, people with this condition develop some secondary sex characteristics, such as increased muscle mass, deepening of the voice, and development of male pattern body hair. The penis and scrotum (the sac of skin that holds the testes) grow larger during this period. In addition to these changes typical of adolescent boys, some affected males may also experience breast enlargement (gynecomastia). Men with this disorder are generally unable to father children (infertile).Children with 17-beta hydroxysteroid dehydrogenase 3 deficiency are often raised as girls. About half of these individuals adopt a male gender role in adolescence or early adulthood.
Reifenstein syndrome
MedGen UID:
82785
Concept ID:
C0268301
Disease or Syndrome
Individuals with androgen insensitivity have a 46,XY karyotype and testes that produce age-appropriate androgen levels but have undermasculinized external genitalia due to defects in androgen action. The phenotype in PAIS varies depending on residual androgen receptor function, ranging from severe undermasculinization presenting as female-like external genitalia to male-appearing genitalia. The typical presentation comprises micropenis, severe hypospadias, and bifid scrotum with or without cryptorchidism (summary by Mongan et al., 2015).
Isolated prolactin deficiency
MedGen UID:
75758
Concept ID:
C0271586
Disease or Syndrome
A reduced ability to secrete prolactin, a protein hormone that is secreted by lactotrophs in the anterior pituitary and that stimulates mammary gland development and milk production.
Hypogonadotropic hypogonadism 7 with or without anosmia
MedGen UID:
82883
Concept ID:
C0271623
Disease or Syndrome
Isolated gonadotropin-releasing hormone (GnRH) deficiency (IGD) is characterized by inappropriately low serum concentrations of the gonadotropins LH (luteinizing hormone) and FSH (follicle-stimulating hormone) in the presence of low circulating concentrations of sex steroids. IGD is associated with a normal sense of smell (normosmic IGD) in approximately 40% of affected individuals and an impaired sense of smell (Kallmann syndrome) in approximately 60%. IGD can first become apparent in infancy, adolescence, or adulthood. Infant boys with congenital IGD often have micropenis and cryptorchidism. Adolescents and adults with IGD have clinical evidence of hypogonadism and incomplete sexual maturation on physical examination. Adult males with IGD tend to have prepubertal testicular volume (i.e., <4 mL), absence of secondary sexual features (e.g., facial and axillary hair growth, deepening of the voice), decreased muscle mass, diminished libido, erectile dysfunction, and infertility. Adult females have little or no breast development and primary amenorrhea. Although skeletal maturation is delayed, the rate of linear growth is usually normal except for the absence of a distinct pubertal growth spurt.
Oligosynaptic infertility
MedGen UID:
140793
Concept ID:
C0403810
Disease or Syndrome
The histologic picture of meiotic arrest is rather constant. Meiotic arrest is characterized by germ cells that enter meiosis and undergo the first chromosomal reduction from 4n to 2n but are then unable to proceed further. This results in tubules containing spermatocytes as the latest developmental stage of germ cells. Meiotically arrested spermatocytes accumulate in the tubules, degenerate, and are easily distinguishable from normal spermatocytes by their partially condensed chromosomes. Although the cause of infertility in patients with meiotic arrest often remains unidentified, this histologic picture can be observed in patients with nonidiopathic infertility as well, such as in the case of microdeletions of the Y chromosome, chromosomal abnormalities, and cryptorchidism, suggesting that different causal factors can result in the same effect (summary by Luetjens et al., 2004). Phenotypic and Genetic Heterogeneity of Spermatogenic Failure Several forms of autosomal spermatogenic failure have been reported. SPGF1 represents an autosomal recessive form of spermatogenic failure associated with defects in meiosis. SPGF2 (108420) represents a form of spermatogenic failure associated with rearrangements on chromosome 1. Another form of spermatogenic failure (SPGF3; 606766), associated with asthenozoospermia, is caused by mutation in the SLC26A8 gene (608480) on chromosome 6p21. A form of azoospermia due to perturbations of meiosis (SPGF4; 270960) is caused by mutation in the SYCP3 gene (604759) on chromosome 12q23. Male infertility due to large-headed, multiflagellar, polyploid sperm (SPGF5; 243060) is caused by mutation in the AURKC gene (603495) on chromosome 19q13. Acrosome malformation resulting in globozoospermia (SPGF6; 102530) can be caused by mutation in the SPATA16 gene (609856) on chromosome 3q26.3. Spermatogenic failure-7 (SPGF7; 612997) is caused by mutation in the CATSPER gene (606389) on chromosome 11q13. Spermatogenic failure-8 (SPGF8; 613957) is caused by mutation in the NR5A1 gene (184757) on chromosome 9q33. Another form of globozoospermia (SPGF9; 613958) is caused by mutation in the DPY19L2 gene (613893) on chromosome 12q14. A form of spermatogenic failure with defective sperm annulus (SPGF10; 614822) is caused by mutation in the SEPT12 gene (611562) on chromosome 16p13. Spermatogenic failure-11 (SPGF11; 615081) is caused by mutation in the KLHL10 gene (608778) on chromosome 17p21. Spermatogenic failure-12 (SPGF12; 615413) is caused by mutation in the NANOS1 gene (608226) on chromosome 10q26. SPGF13 (615841) is caused by mutation in the TAF4B gene (601689) on chromosome 18q11. SPGF14 (615842) is caused by mutation in the ZMYND15 gene (614312) on chromosome 17p13. SPGF15 (616950) is caused by mutation in the SYCE1 gene (611486) on chromosome 10q26. A form of spermatogenic failure due to acephalic spermatozoa (SPGF16; 617187) is caused by mutation in the SUN5 gene (613942) on chromosome 20q11. X-linked forms of spermatogenic failure include SPGFX1 (305700) and SPGFX2 (309120). Y-linked forms of spermatogenic failure include SPGFY1 (400042) and SPGFY2 (415000). Spermatogenic failure can also result from underlying endocrinologic disorders (see, e.g., hypogonadotropic hypogonadism, 146110) or ciliary dyskinesias (see, e.g., CILD1, 244400). Associations Pending Confirmation Azoospermia may be associated with variation in the HSF2 gene (see 140581.0001) or in the PLK4 gene (see 605031.0003). Some forms of male infertility may be associated with variation in the protamine genes PRM1 (182880) and PRM2 (182890). Male infertility may be associated with variation in the NPAS2 gene (603347).
Globozoospermia
MedGen UID:
96048
Concept ID:
C0403825
Finding
The acrosome is a unique structure of the mature spermatozoon, which plays an important role at the site of sperm-zonapellucida binding during the fertilization process. Globozoospermia (also called round-headed spermatozoa) is a human infertility syndrome caused by spermatogenesis defects (Lalonde et al., 1988, Singh, 1992). The most prominent feature of globozoospermia is the malformation of the acrosome and, in the most severe cases, the acrosome is totally absent. Globozoospermia is also characterized by abnormal nuclear shape as well as abnormal arrangement of the mitochondria of the spermatozoon (Battaglia et al., 1997).
Axial osteosclerosis
MedGen UID:
98482
Concept ID:
C0432264
Disease or Syndrome
Ciliary dyskinesia, primary, 2
MedGen UID:
338258
Concept ID:
C1847554
Disease or Syndrome
Primary ciliary dyskinesia (PCD) is associated with situs abnormalities, abnormal sperm motility, and abnormal ciliary structure and function that result in retention of mucus and bacteria in the respiratory tract leading to chronic otosinopulmonary disease. More than 75% of full-term neonates with PCD have ‘neonatal respiratory distress’ requiring supplemental oxygen for days to weeks. Chronic airway infection, apparent in early childhood, results in bronchiectasis that is almost uniformly present in adulthood. Nasal congestion and sinus infections, apparent in early childhood, persist through adulthood. Chronic/recurrent ear infection, apparent in most young children, can be associated with transient or later irreversible hearing loss. Situs inversus totalis (mirror-image reversal of all visceral organs with no apparent physiologic consequences) is present in 40%-50% of individuals with PCD; heterotaxy (discordance of right and left patterns of ordinarily asymmetric structures that can be associated with significant malformations) is present in approximately 12%. Virtually all males with PCD are infertile as a result of abnormal sperm motility.
Retinohepatoendocrinologic syndrome
MedGen UID:
340315
Concept ID:
C1849399
Disease or Syndrome
FRAGILE SITE 16q22
MedGen UID:
342637
Concept ID:
C1850984
Disease or Syndrome
Lubinsky syndrome
MedGen UID:
344596
Concept ID:
C1855859
Disease or Syndrome
Follicle-stimulating hormone deficiency, isolated
MedGen UID:
341603
Concept ID:
C1856716
Disease or Syndrome
Subnormal concentration of follicle stimulating hormone (FSH), associated with mutations in the FSHB gene, encoding follitropin subunit beta.
Gordon Holmes syndrome
MedGen UID:
349137
Concept ID:
C1859305
Disease or Syndrome
Gordon Holmes syndrome is an autosomal recessive adult-onset neurodegenerative disorder characterized by progressive cognitive decline, dementia, and variable movement disorders, such as ataxia and chorea. The neurologic phenotype is associated with hypogonadotropic hypogonadism (summary by Santens et al., 2015).
Deafness, cataract, retinitis pigmentosa, and sperm abnormalities
MedGen UID:
395517
Concept ID:
C2678011
Disease or Syndrome
Ciliary dyskinesia, primary, 13
MedGen UID:
413399
Concept ID:
C2750790
Disease or Syndrome
Primary ciliary dyskinesia (PCD) is associated with situs abnormalities, abnormal sperm motility, and abnormal ciliary structure and function that result in retention of mucus and bacteria in the respiratory tract leading to chronic otosinopulmonary disease. More than 75% of full-term neonates with PCD have ‘neonatal respiratory distress’ requiring supplemental oxygen for days to weeks. Chronic airway infection, apparent in early childhood, results in bronchiectasis that is almost uniformly present in adulthood. Nasal congestion and sinus infections, apparent in early childhood, persist through adulthood. Chronic/recurrent ear infection, apparent in most young children, can be associated with transient or later irreversible hearing loss. Situs inversus totalis (mirror-image reversal of all visceral organs with no apparent physiologic consequences) is present in 40%-50% of individuals with PCD; heterotaxy (discordance of right and left patterns of ordinarily asymmetric structures that can be associated with significant malformations) is present in approximately 12%. Virtually all males with PCD are infertile as a result of abnormal sperm motility.
Spastic paraplegia 46, autosomal recessive
MedGen UID:
473687
Concept ID:
C2828721
Gene or Genome
Autosomal recessive spastic paraplegia-46 (SPG46) is a neurodegenerative disorder characterized by onset in childhood of slowly progressive spastic paraplegia and cerebellar signs. Some patients have cognitive impairment, cataracts, and cerebral, cerebellar, and corpus callosum atrophy on brain imaging (summary by Boukhris et al., 2010 and Martin et al., 2013).
Ciliary dyskinesia, primary, 14
MedGen UID:
462486
Concept ID:
C3151136
Disease or Syndrome
Primary ciliary dyskinesia (PCD) is associated with situs abnormalities, abnormal sperm motility, and abnormal ciliary structure and function that result in retention of mucus and bacteria in the respiratory tract leading to chronic otosinopulmonary disease. More than 75% of full-term neonates with PCD have ‘neonatal respiratory distress’ requiring supplemental oxygen for days to weeks. Chronic airway infection, apparent in early childhood, results in bronchiectasis that is almost uniformly present in adulthood. Nasal congestion and sinus infections, apparent in early childhood, persist through adulthood. Chronic/recurrent ear infection, apparent in most young children, can be associated with transient or later irreversible hearing loss. Situs inversus totalis (mirror-image reversal of all visceral organs with no apparent physiologic consequences) is present in 40%-50% of individuals with PCD; heterotaxy (discordance of right and left patterns of ordinarily asymmetric structures that can be associated with significant malformations) is present in approximately 12%. Virtually all males with PCD are infertile as a result of abnormal sperm motility.
Ciliary dyskinesia, primary, 15
MedGen UID:
462487
Concept ID:
C3151137
Disease or Syndrome
Primary ciliary dyskinesia (PCD) is associated with situs abnormalities, abnormal sperm motility, and abnormal ciliary structure and function that result in retention of mucus and bacteria in the respiratory tract leading to chronic otosinopulmonary disease. More than 75% of full-term neonates with PCD have ‘neonatal respiratory distress’ requiring supplemental oxygen for days to weeks. Chronic airway infection, apparent in early childhood, results in bronchiectasis that is almost uniformly present in adulthood. Nasal congestion and sinus infections, apparent in early childhood, persist through adulthood. Chronic/recurrent ear infection, apparent in most young children, can be associated with transient or later irreversible hearing loss. Situs inversus totalis (mirror-image reversal of all visceral organs with no apparent physiologic consequences) is present in 40%-50% of individuals with PCD; heterotaxy (discordance of right and left patterns of ordinarily asymmetric structures that can be associated with significant malformations) is present in approximately 12%. Virtually all males with PCD are infertile as a result of abnormal sperm motility.
Cortisone reductase deficiency 1
MedGen UID:
764630
Concept ID:
C3551716
Disease or Syndrome
Cortisone reductase deficiency (CRD) results from a failure to regenerate the active glucocorticoid cortisol from cortisone via the enzyme 11-beta-hydroxysteroid dehydrogenase (HSD11B1; 600713). The oxoreductase activity of 11-beta-HSD requires the NADPH-regenerating enzyme hexose-6-phosphate dehydrogenase (H6PD; 138090) within the endoplasmic reticulum. Lack of cortisol regeneration stimulates ACTH-mediated adrenal hyperandrogenism, with males manifesting in early life with precocious pseudopuberty and females presenting in midlife with hirsutism, oligomenorrhea, and infertility. Biochemically, CRD is diagnosed through the assessment of urinary cortisol and cortisone metabolites and consists of measuring the tetrahydrocortisol (THF) plus 5-alpha-THF/tetrahydrocortisone (THE) ratio, which in CRD patients is typically less than 0.1 (reference range, 0.7 to 1.2) (summary by Lavery et al., 2008). Genetic Heterogeneity of Cortisone Reductase Deficiency CORTRD2 (614662) is caused by mutation in the HSD11B1 gene (600713) on chromosome 1q32.
Spermatogenic failure 10
MedGen UID:
766707
Concept ID:
C3553793
Disease or Syndrome
Male infertility has been shown to be associated with a defective annulus, a ring structure that demarcates the midpiece and the principal piece of the sperm tail. The firm attachment of the annulus to the flagellar membrane suggests that it may supply mechanical support and prevent displacement of the caudal mitochondrial helix (summary by Kuo et al., 2012).
Spermatogenic failure 11
MedGen UID:
767367
Concept ID:
C3554453
Disease or Syndrome
Cystic fibrosis with helicobacter pylori gastritis, megaloblastic anemia, and mental retardation
MedGen UID:
812585
Concept ID:
C3806255
Disease or Syndrome
Spermatogenic failure 12
MedGen UID:
815757
Concept ID:
C3809427
Disease or Syndrome
Ciliary dyskinesia, primary, 22
MedGen UID:
815873
Concept ID:
C3809543
Disease or Syndrome
Primary ciliary dyskinesia-22 is an autosomal recessive disorder caused by defective structure and function of cilia or flagella. Ciliary dysfunction causes respiratory distress in term neonates, impaired mucociliary clearance, chronic cough, sinusitis, bronchiectasis, and male infertility. Defective motility of embryonic nodal cilia leads to situs abnormalities in about 50% of patients. CILD22 is characterized by defects of the inner and outer dynein arms (summary by Zariwala et al., 2013).
Primary ciliary dyskinesia 24
MedGen UID:
815964
Concept ID:
C3809634
Disease or Syndrome
Primary ciliary dyskinesia-24 is an autosomal recessive disorder resulting from defects of motile cilia. It is characterized clinically by sinopulmonary infection and subfertility; situs inversus is not observed. Ultrastructural examination of mutant cilia shows defects of the central microtubule complex and radial spokes (summary by Kott et al., 2013). For a phenotypic description and a discussion of genetic heterogeneity of primary ciliary dyskinesia, see 244400.
Primary ciliary dyskinesia 25
MedGen UID:
815971
Concept ID:
C3809641
Disease or Syndrome
Primary ciliary dyskinesia-25 is an autosomal recessive disorder caused by defective ciliary movement. Affected individuals have recurrent upper and lower airway disease, bronchiectasis, and decreased fertility. About half of patients show laterality defects, including situs inversus totalis. Respiratory cilia from patients show defects in the inner and outer dynein arms (summary by Tarkar et al., 2013). For a phenotypic description and a discussion of genetic heterogeneity of primary ciliary dyskinesia, see 244400.
Ciliary dyskinesia, primary, 26
MedGen UID:
816014
Concept ID:
C3809684
Disease or Syndrome
Primary ciliary dyskinesia-26 is an autosomal recessive disorder caused by defective ciliary movement. Affected individuals have neonatal respiratory distress, recurrent upper and lower airway disease, and bronchiectasis. About half of patients show laterality defects, including situs inversus totalis. Respiratory cilia from patients show defects in the inner and outer dynein arms (summary by Austin-Tse et al., 2013). For a general phenotypic description and a discussion of genetic heterogeneity of primary ciliary dyskinesia, see 244400.
Morbid obesity and spermatogenic failure
MedGen UID:
816654
Concept ID:
C3810324
Disease or Syndrome
FRAGILE SITE, DISTAMYCIN A TYPE, RARE, FRA(16)(q22.1)
MedGen UID:
855519
Concept ID:
C3890175
Finding
Female infertility due to zona pellucida defect
MedGen UID:
862728
Concept ID:
C4014291
Disease or Syndrome
CILIARY DYSKINESIA, PRIMARY, 29
MedGen UID:
862971
Concept ID:
C4014534
Disease or Syndrome
Glucocorticoid resistance, generalized
MedGen UID:
798686
Concept ID:
CN205763
Disease or Syndrome
Generalized glucocorticoid resistance is an autosomal dominant disease characterized by increased plasma cortisol concentration and high urinary free cortisol, resistance to adrenal suppression by dexamethasone, and the absence of clinical stigmata of Cushing syndrome. The clinical expression of the disease is variable. Common features include hypoglycemia, hypertension, and metabolic alkalosis. In females, overproduction of adrenal androgens has been associated with infertility, male-pattern baldness, hirsutism, and menstrual irregularities. Other features include chronic fatigue and profound anxiety (summary by Chrousos et al., 1983; Donner et al., 2013).

Recent clinical studies

Etiology

Palomba S, Homburg R, Santagni S, La Sala GB, Orvieto R
Reprod Biol Endocrinol 2016 Nov 4;14(1):76. doi: 10.1186/s12958-016-0211-8. PMID: 27814762Free PMC Article
Stevenson EL, Hershberger PE, Bergh PA
J Obstet Gynecol Neonatal Nurs 2016 Jan-Feb;45(1):100-10; quiz e1-2. Epub 2015 Dec 1 doi: 10.1016/j.jogn.2015.10.006. PMID: 26815804
Crawford S, Boulet SL, Jamieson DJ, Stone C, Mullen J, Kissin DM
Fertil Steril 2016 Feb;105(2):347-55. Epub 2015 Oct 26 doi: 10.1016/j.fertnstert.2015.10.009. PMID: 26515377Free PMC Article
Gameiro S, Boivin J, Dancet E, de Klerk C, Emery M, Lewis-Jones C, Thorn P, Van den Broeck U, Venetis C, Verhaak CM, Wischmann T, Vermeulen N
Hum Reprod 2015 Nov;30(11):2476-85. Epub 2015 Sep 7 doi: 10.1093/humrep/dev177. PMID: 26345684
Chen J, Zhong C, Liang H, Yang Y, Zhang O, Gao E, Chen A, Yuan W, Wang J, Sun F, Miao M
Eur J Obstet Gynecol Reprod Biol 2015 Nov;194:68-72. Epub 2015 Aug 21 doi: 10.1016/j.ejogrb.2015.08.016. PMID: 26334357

Diagnosis

Yang H, Yin J, Ficarrotta K, Hsu SH, Zhang W, Cheng C
J Endocrinol Invest 2016 Jul;39(7):785-91. Epub 2016 Feb 17 doi: 10.1007/s40618-016-0435-7. PMID: 26886939Free PMC Article
Stevenson EL, Hershberger PE, Bergh PA
J Obstet Gynecol Neonatal Nurs 2016 Jan-Feb;45(1):100-10; quiz e1-2. Epub 2015 Dec 1 doi: 10.1016/j.jogn.2015.10.006. PMID: 26815804
Crawford S, Boulet SL, Jamieson DJ, Stone C, Mullen J, Kissin DM
Fertil Steril 2016 Feb;105(2):347-55. Epub 2015 Oct 26 doi: 10.1016/j.fertnstert.2015.10.009. PMID: 26515377Free PMC Article
Alur S, Wang H, Hoeger K, Swan SH, Sathyanarayana S, Redmon BJ, Nguyen R, Barrett ES
Fertil Steril 2015 Nov;104(5):1227-35. Epub 2015 Aug 11 doi: 10.1016/j.fertnstert.2015.07.1150. PMID: 26275821Free PMC Article
Levine JM, Kelvin JF, Quinn GP, Gracia CR
Cancer 2015 May 15;121(10):1532-9. Epub 2015 Feb 3 doi: 10.1002/cncr.29181. PMID: 25649243

Therapy

Palomba S, Homburg R, Santagni S, La Sala GB, Orvieto R
Reprod Biol Endocrinol 2016 Nov 4;14(1):76. doi: 10.1186/s12958-016-0211-8. PMID: 27814762Free PMC Article
Stevenson EL, Hershberger PE, Bergh PA
J Obstet Gynecol Neonatal Nurs 2016 Jan-Feb;45(1):100-10; quiz e1-2. Epub 2015 Dec 1 doi: 10.1016/j.jogn.2015.10.006. PMID: 26815804
Crawford S, Boulet SL, Jamieson DJ, Stone C, Mullen J, Kissin DM
Fertil Steril 2016 Feb;105(2):347-55. Epub 2015 Oct 26 doi: 10.1016/j.fertnstert.2015.10.009. PMID: 26515377Free PMC Article
Sangster SL, Lawson KL
J Obstet Gynaecol Can 2015 Dec;37(12):1072-8. PMID: 26637079
Alur S, Wang H, Hoeger K, Swan SH, Sathyanarayana S, Redmon BJ, Nguyen R, Barrett ES
Fertil Steril 2015 Nov;104(5):1227-35. Epub 2015 Aug 11 doi: 10.1016/j.fertnstert.2015.07.1150. PMID: 26275821Free PMC Article

Prognosis

Palomba S, Homburg R, Santagni S, La Sala GB, Orvieto R
Reprod Biol Endocrinol 2016 Nov 4;14(1):76. doi: 10.1186/s12958-016-0211-8. PMID: 27814762Free PMC Article
Xiao CW, Agbo C, Dahan MH
Arch Gynecol Obstet 2016 Jan;293(1):211-7. Epub 2015 Aug 20 doi: 10.1007/s00404-015-3850-7. PMID: 26288981
Alur S, Wang H, Hoeger K, Swan SH, Sathyanarayana S, Redmon BJ, Nguyen R, Barrett ES
Fertil Steril 2015 Nov;104(5):1227-35. Epub 2015 Aug 11 doi: 10.1016/j.fertnstert.2015.07.1150. PMID: 26275821Free PMC Article
Cookingham LM, Van Voorhis BJ, Ascoli M
J Assist Reprod Genet 2015 May;32(5):737-45. Epub 2015 Feb 15 doi: 10.1007/s10815-015-0447-9. PMID: 25682117Free PMC Article
van Roode T, Dickson NP, Righarts AA, Gillett WR
Fertil Steril 2015 Apr;103(4):1053-1058.e2. Epub 2015 Jan 27 doi: 10.1016/j.fertnstert.2014.12.121. PMID: 25637476

Clinical prediction guides

Xiao CW, Agbo C, Dahan MH
Arch Gynecol Obstet 2016 Jan;293(1):211-7. Epub 2015 Aug 20 doi: 10.1007/s00404-015-3850-7. PMID: 26288981
Alur S, Wang H, Hoeger K, Swan SH, Sathyanarayana S, Redmon BJ, Nguyen R, Barrett ES
Fertil Steril 2015 Nov;104(5):1227-35. Epub 2015 Aug 11 doi: 10.1016/j.fertnstert.2015.07.1150. PMID: 26275821Free PMC Article
Maroufizadeh S, Karimi E, Vesali S, Omani Samani R
Int J Gynaecol Obstet 2015 Sep;130(3):253-6. Epub 2015 Jun 10 doi: 10.1016/j.ijgo.2015.03.044. PMID: 26100348
Kersten FA, Hermens RP, Braat DD, Hoek A, Mol BW, Goddijn M, Nelen WL; Improvement Study Group.
Hum Reprod 2015 Jan;30(1):71-80. Epub 2014 Oct 21 doi: 10.1093/humrep/deu262. PMID: 25336712
Martins MV, Costa P, Peterson BD, Costa ME, Schmidt L
Fertil Steril 2014 Dec;102(6):1716-22. Epub 2014 Oct 22 doi: 10.1016/j.fertnstert.2014.09.007. PMID: 25439808

Recent systematic reviews

Palomba S, Homburg R, Santagni S, La Sala GB, Orvieto R
Reprod Biol Endocrinol 2016 Nov 4;14(1):76. doi: 10.1186/s12958-016-0211-8. PMID: 27814762Free PMC Article
Stevenson EL, Hershberger PE, Bergh PA
J Obstet Gynecol Neonatal Nurs 2016 Jan-Feb;45(1):100-10; quiz e1-2. Epub 2015 Dec 1 doi: 10.1016/j.jogn.2015.10.006. PMID: 26815804
Shiadeh MN, Niyyati M, Fallahi S, Rostami A
Parasitol Res 2016 Feb;115(2):469-77. Epub 2015 Nov 16 doi: 10.1007/s00436-015-4827-y. PMID: 26573517
Gameiro S, Boivin J, Dancet E, de Klerk C, Emery M, Lewis-Jones C, Thorn P, Van den Broeck U, Venetis C, Verhaak CM, Wischmann T, Vermeulen N
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