{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T07:27:11Z","timestamp":1792740431984,"version":"4.5.0"},"reference-count":18,"publisher":"BMJ","issue":"6510","license":[{"start":{"date-parts":[[1985,12,14]],"date-time":"1985-12-14T00:00:00Z","timestamp":503366400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1985,12,14]]},"abstract":"<jats:p>Specialist infertility practice was studied in a group of 708 couples within a population of residents of a single health district in England. They represented an annual incidence of 1.2 couples for every 1000 of the population. At least one in six couples needed specialist help at some time in their lives because of an average of infertility of 21\/2 years, 71% of whom were trying for their first baby. Those attending gynaecology clinics made up 10% of new and 22% of all attendances. Failure of ovulation (amenorrhoea or oligomenorrhoea) occurred in 21% of cases and was successfully treated (two year conception rates of 96% and 78%). Tubal damage (14%) had a poor outlook (19%) despite surgery. Endometriosis accounted for infertility in 6%, although seldom because of tubal damage, cervical mucus defects or dysfunction in 3%, and coital failure in up to 6%. Sperm defects or dysfunction were the commonest defined cause of infertility (24%) and led to a poor chance of pregnancy (0-27%) without donor insemination. Obstructive azoospermia or primary spermatogenic failure was uncommon (2%) and hormonal causes of male infertility rare. Infertility was unexplained in 28% and the chance of pregnancy (overall 72%) was mainly determined by duration of infertility. In vitro fertilisation could benefit 80% of cases of tubal damage and 25% of unexplained infertility--that is, 18% of all cases, representing up to 216 new cases each year per million of the total population.<\/jats:p>","DOI":"10.1136\/bmj.291.6510.1693","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"1693-1697","source":"Crossref","is-referenced-by-count":839,"title":["Population study of causes, treatment, and outcome of infertility."],"prefix":"10.1136","volume":"291","author":[{"given":"M G","family":"Hull","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C M","family":"Glazener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N J","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D I","family":"Conway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P A","family":"Foster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R A","family":"Hinton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Coulson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P A","family":"Lambert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E M","family":"Watt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K M","family":"Desai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1985,12,14]]},"reference":[{"key":"ref_1","article-title":"Report of the commtuee of inquiry into human fertilisation and embryology","author":"Warnock, M.","year":"1984","unstructured":"Warnock M. Report of the commtuee of inquiry into human fertilisation and embryology. London: HMSO, 1984."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S0015-0282(16)32231-2","article-title":"Statistical contributions to the study of human fertility","volume":"7","author":"Tietze, C.","year":"1956","unstructured":"Tietze C. Statistical contributions to the study of human fertility. Fertil Steril 1956;7:88-95.","journal-title":"Fertil Steril"},{"key":"ref_3","first-page":"385","article-title":"Fertility after the discontinuation of intrauterine and oral contraception","volume":"13","author":"Tietze, C.","year":"1968","unstructured":"Tietze C. Fertility after the discontinuation of intrauterine and oral contraception. Int7 Fertil 1968;13:385-9."},{"key":"ref_4","first-page":"\"1681","article-title":"Anovulatory and ovulatory infertility: results with simplified management. Br MedJf","volume-title":"The value of a single serum progesterone measurement in the midluteal phase as a criterion of a potentially fertile cycle ovulation\") derived from treated and untreated conception cycles","volume":"284","author":"Hull MGR, Savage PE, Bromham DR, Ismail AAA, Morris AF.","year":"1982","unstructured":"Hull MGR, Savage PE, Bromham DR. Anovulatory and ovulatory infertility: results with simplified management. Br MedJf 1982;284:1681-5. S Hull MGR, Savage PE, Bromham DR, Ismail AAA, Morris AF. The value of a single serum progesterone measurement in the midluteal phase as a criterion of a potentially fertile cycle ovulation\") derived from treated and untreated conception cycles. Fertil Steril 1982;37: 355-60."},{"key":"ref_5","first-page":"183","article-title":"The prognostic value of seminal analysis in infertility","volume":"92","author":"Glazener, C.M.A.; Kelly, N.J.; Coulson, C.","year":"1985","unstructured":"Glazener CMA, Kelly NJ, Coulson C, et al. The prognostic value of seminal analysis in infertility. BrJf Obstet Gvnaecol 1985;92:183-4.","journal-title":"BrJf Obstet Gvnaecol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/j.1471-0528.1982.tb04700.x","article-title":"Prognostic value of the postcoital test: prospective study based on time-specific cumulative conception rates","volume":"89","year":"1982","unstructured":"Hull MGR, Savage PE, Bromham DR. Prognostic value of the postcoital test: prospective study based on time-specific cumulative conception rates. BrJ Obstet Gs'naecol 1982;89:299-305.","journal-title":"BrJ Obstet Gs'naecol"},{"key":"ref_7","article-title":"Clinical management of the normal infertile couple","author":"Glazener, C.M.A.","year":"1984","unstructured":"Glazener CMA. Clinical management of the normal infertile couple. Bristol: Bristol University, 1984. (MD Thesis.)"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0140-6736(84)92113-5","article-title":"Chlamydial serology in fertile and infertile women","volume":"i:","author":"Conway, D.; Glazener, C.M.A.; Caul, E.O.","year":"1984","unstructured":"Conway D, Glazener CMA, Caul EO, et al. Chlamydial serology in fertile and infertile women. Lantcet 1984;i: 191-3.","journal-title":"Lantcet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/S0015-0282(16)46630-6","article-title":"The effectiveness of danazol on subsequent fertility in minimal endometriosis","volume":"38","author":"Seibel, M.M.; Berger, M.J.; Weinstein, F.G.; I'avmor, M.L.","year":"1982","unstructured":"Seibel MM, Berger MJ, Weinstein FG, I'avmor ML. The effectiveness of danazol on subsequent fertility in minimal endometriosis. Fertil Steril 1982;38:534-7.","journal-title":"Fertil Steril"},{"key":"ref_10","first-page":"263","article-title":"Simplified management of anovulatory and ovulatory infertility","author":"Hull, M.G.R.","year":"1983","unstructured":"Hull MGR. Simplified management of anovulatory and ovulatory infertility. London: London University, 1983:263-5. (MD 'hesis.)"},{"key":"ref_11","first-page":"236","article-title":"Endometriosis and ovulatory disorder: reduced fertilisation in-vitro compared with tubal and unexplained infertility","volume":"ii:","author":"Wardle, P.G.; Mitchell, J.D.; McLaughlin, E.A.; Ray, B.D.; McDermott, A.; Hull, M.G.R.","year":"1985","unstructured":"Wardle PG, Mitchell JD, McLaughlin EA, Ray BD, McDermott A, Hull MGR. Endometriosis and ovulatory disorder: reduced fertilisation in-vitro compared with tubal and unexplained infertility. Lancet 1985;ii:236-9.","journal-title":"Lancet"},{"key":"ref_12","first-page":"371","article-title":"Djahanbakhch 0. 'I'he role ol mucus-sperm interation in infertilits of tinknown aetiology. Br.7 Obstet Gvnaccol","volume":"91","author":"Schats, R.; Aitken, R.J.; Templeton, A.A.","year":"1984","unstructured":"Schats R, Aitken RJ, Templeton AA, Djahanbakhch 0. 'I'he role ol mucus-sperm interation in infertilits of tinknown aetiology. Br.7 Obstet Gvnaccol 1984;91:371-6."},{"key":"ref_13","first-page":"245","article-title":"Human in-vitro fertilisation, invivo sperm penetration of cervical mucus, and unexplained infertility","volume":"ii:","author":"Hull, M.G.R.; Joyce, D.N.; McLeod, F.N.; Ray, B.D.; McDermott, A.","year":"1984","unstructured":"Hull MGR, Joyce DN, McLeod FN, Ray BD, McDermott A. Human in-vitro fertilisation, invivo sperm penetration of cervical mucus, and unexplained infertility. Lancet 1984;ii:245-6.","journal-title":"Lancet"},{"key":"ref_14","article-title":"In-vitro fertilization: a treatment for male infertility","volume-title":"Fertil","author":"Cohen, J.; Edwards, R.G.; Fehilly, C.","unstructured":"Cohen J, Edwards RG, Fehilly C, et al. In-vitro fertilization: a treatment for male infertility. Fertil Sterl (in press)."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/S0140-6736(84)90520-8","article-title":"Male infertility and in-vitro fertilisation","volume":"ii:","author":"Hull, M.G.R.; Glazener, C.M.A.","year":"1984","unstructured":"Hull MGR, Glazener CMA. Male infertility and in-vitro fertilisation. Lancet 1984;ii:231.","journal-title":"Lancet"},{"key":"ref_16","first-page":"755","article-title":"The relationship of tubal blockage, infertility of unknown cause, suspected male infertility and endometriosis to success of in-vitro fertilisation and embryo transfer","volume-title":"Fertil Steril","volume":"40","author":"Mahadevan, M.M.; Trounson, A.O.; Leeton, J.F.","year":"1983","unstructured":"Mahadevan MM, Trounson AO, Leeton JF. The relationship of tubal blockage, infertility of unknown cause, suspected male infertility and endometriosis to success of in-vitro fertilisation and embryo transfer. Fertil Steril 1983;40:755-62."},{"key":"ref_17","article-title":"Results of donor insemination related to specific male infertility and unsuspected female infertility. Br O)bstet Gvnaecol","author":"Foss, G.L.; Hull, M.G.R.","unstructured":"Foss GL, Hull MGR. Results of donor insemination related to specific male infertility and unsuspected female infertility. Br O)bstet Gvnaecol (in press)."},{"key":"ref_18","author":"I3","year":"1985","unstructured":"(Accepted I3.August 1985)"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.291.6510.1693","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.291.6510.1693","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T19:42:41Z","timestamp":1765482161000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.291.6510.1693"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1985,12,14]]},"references-count":18,"journal-issue":{"issue":"6510","published-online":{"date-parts":[[1985,12,14]]},"published-print":{"date-parts":[[1985,12,14]]}},"alternative-id":["10.1136\/bmj.291.6510.1693"],"URL":"https:\/\/doi.org\/10.1136\/bmj.291.6510.1693","relation":{},"ISSN":["0267-0623","1468-5833"],"issn-type":[{"value":"0267-0623","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1985,12,14]]}}}