Experience of a comprehensive infertility clinic in the Department of Obstetrics and Gynaecology, University of Singapore.

ABSTRACT

PIP The diagnosis, treatment, and pregnancy outcome for 709 infertile couples who attended the comprehensive infertility clinic of the University of Singapore's Department of Obstetrics and Gynecology from 1970-1974 are presented. Investigations for most of the couples were completed within 3 months. This short investigative period was attributable primarly to the use of laparoscopy to diagnose female infertility. In 22.5% of the 709 cases infertility was due to ovulation problems. After treatment eith either clomiphene, human pituitory gonadotrophin, or a combination of clomiphene and human chorinic gonadotrophin, pregnancy was achieved in 30.6% of the cases. 11.7% or 83 of the 709 infertility cases were attributed to blocked tubes. 28 of these patients received tubal surgery, but only 14.3% or 4 of these cases resulted in pregnancy. In 14.7% of the 709 cases, infertility was attributed to endometriosis. 90% of the patients with endometriosis were asymptomatic, and the liesons discovered by laparoscopy, were very small. Pregnancy eventually occurred in 27.6% of the cases treated for endometriosis. In 5.8% of the 709 cases infertility was due to mixed gynecological problems, and after treatment, conception occurred among 31.7% of the cases. For 23.1%, or 147 of the 709 couples, infertility was attributed to either oligospermia or azoospermia. 85 of the 147 patients were given hormone therapy and in 12.9% of these cases pregnancy was achieved. 14 of the 147 patients were treated with antibotics for 3-6 months and in 14.3% of these cases pregnancy was achieved. 9 of the 147 patients were surgically treated and in 4 of these cases pregnancy later occurred. 20 of the 147 couples were treated with artifical insemination of donor semen and in 25.0% of these cases pregnancy occurred. Another 19 of the 147 cases were treated with artificial insemination with the husband's semen and conception occurred in 26.8% of these cases. The remaining 22.1% of the 709 couples were apparently normal and 47.8% of these untreated couples later achieved pregnancy.^ieng