Evaluating practice at an Irish tertiary level fertility clinic 1995/98.

This paper audits patients patterns and the diagnostic activities of the Rotunda Hospital, Infertility Clinic by following 186 new patients first attending between 1st March 1995 and 28th February 1996 and their progress in the clinic through to 28th February 1998. Sixty-four percent of patients came from the Eastern Health Board. Sixty-nine per cent had been previously investigated elsewhere. The non-notified drop-out rate was 23%. Of the 158 patients fully investigated, the male partner was the major factor in 27% of couples. Tubal problems accounted for 20% and endometriosis 13%. An ovulation factor was found in 13%. Twenty-seven percent of couples were given the label of unexplained infertility. In 8% more than one factor was present. Fifty-five percent were referred on for IVF/ICSI. Many at this tertiary referral centre had already attended elsewhere. A very high proportion of these had repeat investigations to complete the fertility profile. This policy is questioned as it is not cost effective. The incidence of cause of infertility in the main has little changed in 15 years.