Definitions of infertility and recurrentpregnancy loss: a committee opinion

Practice Committee of the American Society for Reproductive Medicine

American Society for Reproductive Medicine, Birmingham, Alabama

Use your smartphone

This document contains the definitions of infertility and recurrent pregnancy loss as defined bythe Practice Committee of the American Society for Reproductive Medicine. It replaces the doc-ument titled, ‘‘Definitions of Infertility and Recurrent Pregnancy Loss,’’ last published in 2008,Fertil Steril 2008;90(Suppl 3):S60. (Fertil Steril� 2013;99:63. �2013 by American Society forReproductive Medicine.)

Discuss: You can discuss this article with its authors and with other ASRM members at http://fertstertforum.com/goldsteinj-infertility-recurrent-pregnancy-practice-committee/

to scan this QR codeand connect to thediscussion forum forthis article now.*

* Download a free QR code scanner by searching for “QRscanner” in your smartphone’s app store or app marketplace.

I nfertility is a disease,* defined bythe failure to achieve a successfulpregnancy after 12 months or

more of appropriate, timed unprotectedintercourse or therapeutic donor in-semination. Earlier evaluation andtreatment may be justified based onmedical history and physical findingsand is warranted after 6 months forwomen over age 35 years.

Recurrent pregnancy loss is a dis-ease* distinct from infertility, definedby two or more failed pregnancies.When the cause is unknown, each preg-nancy loss merits careful review to de-termine whether specific evaluationmay be appropriate.

For purposes of determining whenevaluation and treatment for infertilityor recurrent pregnancy loss areappropriate, pregnancy is defined asa clinical pregnancy documented byultrasonography or histopathologicexamination.

*Disease is ‘‘any deviation from or interruption oforgan, or system of the body as manifested bypathology, and prognosis may be known or un

Received September 13, 2012; accepted September 1No reprints will be available.Correspondence: Practice Committee, American Soci

ery Hwy., Birmingham, AL 35216 (E-mail: ASRM

Fertility and Sterility® Vol. 99, No. 1, January 2013 0Copyright ©2013 American Society for Reproductivehttp://dx.doi.org/10.1016/j.fertnstert.2012.09.023

VOL. 99 NO. 1 / JANUARY 2013

Acknowledgments: This report wasdeveloped under the direction of thePractice Committee of the AmericanSociety for Reproductive Medicine asa service to its members and other prac-ticing clinicians. Although this docu-ment reflects appropriate managementof a problem encountered in the prac-tice of reproductive medicine, it is notintended to be the only approved stan-dard of practice or to dictate an exclu-sive course of treatment. Other plansof management may be appropriate,taking into account the needs of the in-dividual patient, available resources,and institutional or clinical practicelimitations. The Practice Committeeand the Board of Directors of the Amer-ican Society for Reproductive Medicinehave approved this report.

The following members of theASRM Practice Committee participatedin the development of this document.All Committee members disclosed

the normal structure or function of any part,characteristic symptoms and signs; the etiology,known’’ (1).

7, 2012; published online October 22, 2012.

ety for Reproductive Medicine, 1209 Montgom-@asrm.org).

015-0282/$36.00Medicine, Published by Elsevier Inc.

commercial and financial relationshipswith manufacturers or distributors ofgoods or services used to treat pa-tients. Members of the Committeewho were found to have conflicts ofinterest based on the relationshipsdisclosed did not participate in thediscussion or development of thisdocument.

Samantha Pfeifer, M.D.; JeffreyGoldberg, M.D.; Roger Lobo, M.D.;Michael Thomas, M.D.; Eric Widra,M.D.; Mark Licht, M.D.; John Collins,M.D.; Marcelle Cedars, M.D.; MichaelVernon, Ph.D.; Owen Davis, M.D.;Clarisa Gracia, M.D., M.S.C.E.; WilliamCatherino, M.D., Ph.D.; Kim Thornton,M.D.; Robert Rebar, M.D.; Andrew LaBarbera, Ph.D.

REFERENCE1. Dorland’s Illustrated Medical Dictionary. 29th

Edition. Philadelphia: Saunders; 2000.

63