A greater role for GPs would improve infertility management in the UK, according to a study in the north-east of England.
The study looked at referral patterns and outcomes in 797 infertile couples presenting at 58 practices in Northumberland and Tyne and Wear between January 2005 and June 2006.
A diagnosis was recorded in 64 per cent of couples after 12 months. Diagnosis was made in primary care in 6 per cent of cases, and the rest after referral.
Of the couples that reached diagnosis, 51 per cent were offered IVF or intracytoplasmic sperm injection as first line-therapy, but 36 per cent of these were initially referred to a non-HFEA licensed fertility unit and required onward referral before they could begin treatment.
Lead researcher and GP Dr Scott Wilkes from the University of Sunderland said that increasing the capacity of GPs to diagnose infertility would cut misdirected referrals.
He backed increasing GP access to fallopian tube assessment with open access hysterosalpingography (HSG).
'GPs have the ability to check for sperm and ovulatory problems, but they do not usually have the ability to test the fallopian tubes. Therefore GPs currently cannot make a diagnosis for these patients.
'The 36 per cent of patients initially misdirected to a centre where they could not be treated directly reflects the lack of access that GPs have to tubal assessment with HSG.
'These couples are being referred blindly to a fertility centre that may or may not be the right one because they have had no diagnosis made.'
Mr Laurence Shaw, consultant gynaecologist and deputy director of the London Bridge Fertility Centre agreed GPs should be more involved in infertility assessment.
'GPs should do a sperm count and blood tests to check for ovulation. If the patient wants an HSG I would have no objection to that being organised in primary care, as long as the GP was trained to identify who would benefit,' he said.
But bypassing secondary care could mean patients were treated with IVF inappropriately, he warned.
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