Evaluation, therapy, and outcome in 493 infertile couples.

From 1973 through 1979, 493 infertile couples were evaluated for their infertility problem, allowing for a minimum follow-up of 1 year and a maximum follow-up of 7 years. Accurate records were kept on margin-punched cards for easy review and updating. Ovulation defects; male factor problems, and tubal disease accounted for 60% of the diagnosed causes of infertility. No diagnosis was made in 25% of the patients studied. Therapy began as soon as indicated and continued concurrently as the diagnostic evaluation progressed. Among the 493 infertile couples, 257 (52%) patients had a successful outcome; 90% of this group conceived by 1 year after the initial visit. One hundred thirty-seven patients underwent both hysterosalpingography and laparoscopy during their diagnostic evaluation. The interpretation of the hysterosalpingogram was wrong in about one third of the cases. Of 37 (7.5%) undiagnosed patients who underwent complete evaluation, including visualization of the pelvis by either laparoscopy or laparotomy, only 12 eventually conceived, 11 by the end of 1 year from the initial visit.