article critique

Running head : MANAGEMENT OF INFERTILITY IN WOMEN

Infertility and Management

Student Name

Place

January 14 , 2007

Abstract

The article selected for critical analysis is Diagnosis and Management of Female Infertility ' by Samuel Smith , Samantha M . Pfeifer and John A Collins from the Journal of American Medical Association (2003

Infertility and Management

On careful reading of the article Diagnosis and Management of Female Infertility ' it is clear that diagnosis is not given preference and more of management of infertility is explained

The article in question is more of

a one sided discussion , since it describes about the management of female infertility . The article is silent with regards to motility and sperm count in the semen of a male though these factors play an equally important role for the female not attaining pregnancy . It is not clear as to how Intracytoplasmic sperm injection (ICSI ) could change the management of male infertility

A mention has been made as to the location of sample study , how the samples were selected ? Can the sample be considered to represent the general population ? Does the sample consist of people belonging to different racial communities ? Was the genetic history of these samples collected before the study was conducted

In the table under ovulation diss , Hyperprolactinemia with 52 cases is mentioned in addition to Oligomenorrhea (294 cases ) and Amenorrhea (40 cases ) but no mention is made in the article in this regard . No attempt is made to investigate the lower live birth rate in case of Hyperprolactinemia . Similarly under Tubal disease less than 50 of cases attribute to complete obstruction , whereas more than 50 attribute to other reasons but higher live birth rate . The authors have failed to mention this important point and omitted the investigation in this regard

At one stage the authors state that old tests are no longer carried out in the light of useful new tests but on the contrary they also state that tests to identify cervical mucous factors ' is still being adopted and is considered as useful by some physicians

It is stated that infertility is a powerful prognostic factor reflecting genetic and other causes of infertility , but it is not clear or investigated as to what exactly could be the genetic factors causing infertility . If genetic factors are the causes for infertility , Can these genetic factors be rectified ? Are these genetic factors present in males or in females ? If the genetic factors are in males or females are they from maternal or paternal side ? On which chromosome are these genetic factors present ? These questions need to be answered to state that genetic factors play an important role in causing infertility

It is stated that adjunctive use of insulin sensitizing agents could prove to be useful in women exhibiting resistance to treatment with clomiphene citrate and also those suffering from polycystic ovary syndrome this was stated to lead to restoration of ovulation , but no scientific evidence is cited by the authors here

The unexplained infertility concentrates more on age factor than any other...