July 2015

All the papers from the July 2015 issue of Fertility and Sterility.

Preconception risk stratification before fertility care

Care for the medically complex woman who desires fertility is an increasingly common event. Deciding when and whether one should proceed to fertility care has implications for the intended parents, the resulting offspring, and the health-care systems that care for these individuals. Significant barriers to assessment and communication with these patients include the patient’s desire to conceive despite major medical concerns, the lack of tools to communicate the risks, and the reluctance of health-care providers to limit access to medically assisted pregnancy.

Who are we A perspective on the reproductive endocrinologist and infertility specialist in the 21st century

Reproductive endocrinology and infertility (REI) evolved as a subspecialty of obstetrics and gynecology to foster expertise in the scientific underpinnings and clinical applications of all reproductive disorders. Indeed, as mandated by the American Board of Obstetrics and Gynecology (ABOG), graduates of REI fellowships are expected to become experts in diverse areas ranging from the understanding of the complexities of menstrual cycle physiology to dealing with anatomic and functional disorders related to menstrual cyclicity, fertility, and the ability to maintain a pregnancy.

Are reproductive endocrinologists still gynecologists

When the subspecialty of reproductive endocrinology and infertility (REI) was formed within obstetrics and gynecology, the original focus was gynecologic and reproductive issues ranging from puberty through menopause. Expertise in the underpinning and orchestration of the menstrual cycles at the level of the hypothalamus, pituitary, ovary, and uterus allowed attention to both conception and contraception. Reproductive endocrinologists were consultants for complex gynecologic conditions such as management of fibroids, endometriosis, and abnormal bleeding, and REI was at the forefront of microsurgical techniques including tubal surgery and surgery to conserve the ovary.