Georgia Reproductive Specialists
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The purpose of this proposal is to outline suggested clinical pathways for the management of infertility and common reproductive endocrinology problems. The goal is to create an approach that provides the greatest success while using limited resources in the most cost-effective fashion.
A traditional approach to the management of Reproductive Endocrinology & Infertility problems can be found in any traditional text. However, most texts do not take into account the limited availability of resources within a managed care environment, and do not address the issue of stratification of care into that provided by an OB/GYN generalist and that provided by the reproductive endocrinology subspecialist. To that end, this outline will attempt to focus on what care is best provided by which practitioner. To design a cost-effective, medically appropriate evaluation and treatment plan, we must take the patient’s age into consideration. While there is little necessity to initiate aggressive therapy for the 20 year old with unexplained infertility, those over 35 deserve a more aggressive approach.
Eric Flisser, M.D.©
RMA of New York
635 Madison Ave, 10th Floor
New York, NY 10022
Telephone: (212) 756-5777
Infertility therapy can be emotionally taxing and financially burdensome. The “necessity” of such therapy is the source of much debate, since not having children is not, by itself, considered a disease, and therefore many insurers consider treatment for subfertility a luxury, rather than a pathologic condition requiring treatment. The field of third-party insurers is filled with seemingly arbitrary decisions on what deserves reimbursement. Anyone who has ever signed up for a health plan is familiar with “in network” physicians or benefits. In addition, some prescribed medications may be covered, but others are not – and the group of medications “on formulary” vary from plan to plan.
By G. David Adamson, MD, FRCSC, FACOG, FACS©
Board Certified, Reproductive Endocrinology and Infertility
Fertility Physicians of Northern California
2581 Samaritan Drive, Suite 302, San Jose, CA 95124 (800) 597 2234
540 University Avenue, Suite 200, Palo Alto, CA 94301 (800) 497-2234
Many couples who might successfully utilize IVF techniques to build their families fail to benefit from these technologies. Although roughly half of the three million infertile couples in this coungtry seek medical intervention to have a child, the overwhelming majority stop short of IVF. This is true even when their chances of achieving a live birth through that technology are good.
Keith A Hansen M.D.©
Sanford Health Fertility and Reproductive Medicine
1500 W. 22nd Street, Suite 102
Sioux Falls, SD 57105
There are no such things as applied sciences, only applications of science. – Louis Pasteur
Preterm birth remains a cause of significant morbidity and mortality in the newborn. In 2008, the March of Dimes reported that 11.9 percent of all live-born infants were born premature in the state of South Dakota. After congenital anomalies, preterm birth is a leading cause of morbidity and mortality in neonates. Preterm neonates are at higher risk of complications, which are increased in frequency and severity the earlier in gestation at the time of delivery. These complications comprise, but are not limited to, intraventricular hemorrhage, necrotizing enterocolitis, bronchopulmonary dysplasia and the need for prolonged neonatal intensive care unit stays. These difficulties are not only life-threatening but also can have a significant impact on neurodevelopment and the need for lifelong specialized medical care.