Moghissi K S, Wallach E E
Fertil Steril. 1983 Jan;39(1):5-21. doi: 10.1016/s0015-0282(16)46750-6.
To recapitulate, four questions must be raised when the couple has been evaluated and found to be normal: (1) Was the infertility evaluation complete in terms of modern standards? (2) Were the results of studies and observations appropriately interpreted? (3) Has a factor which was considered within normal limits and compatible with fertility at the onset of the workup changed during the course of the evaluation? (4) How accessible for evaluation are processes necessary for conception which occur within the reproductive tract? Both members of the couple as well as the managing physician are frustrated and plagued by feelings of inadequacy when no positive findings can be identified during the course of an infertility evaluation. This situation obviously requires of the physician a combination of delicacy, patience, and considerable attention to each detail of the evaluation which has just been completed. The material herein was designed to raise suggestions for approaches to such couples when faced with the designation of "unexplained infertility."
概括来说，当一对夫妇经过评估被认定为正常时，必须提出四个问题：（1）按照现代标准，不孕不育评估是否完整？（2）各项研究和观察结果是否得到了恰当的解读？（3）在检查开始时被认为在正常范围内且与生育能力相符的因素，在评估过程中是否发生了变化？（4）生殖道内受孕所需的过程在评估中是否易于进行？如果在不孕不育评估过程中未发现任何阳性结果，夫妇双方以及主治医生都会感到沮丧，并因觉得自己无能而备受困扰。显然，这种情况要求医生既要细致入微、有耐心，又要对刚刚完成的评估的每个细节予以相当的关注。本文旨在针对面对“不明原因不孕”诊断的此类夫妇，提出应对方法的建议。
