| Infertility associated with precoital ovulation in observant Jewish couples; prevalence, treatment, efficacy and side effects. | |
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MedLine Citation:
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PMID: 22693790 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Religious (halachic*) infertility' results from precoital ovulation prior to immersion in a ritual bath (mikveh) 7 days after menstruation, as mandated by Jewish religious law. Previous authors recommended treatment with estradiol to postpone ovulation and enhance pregnancy rates. OBJECTIVES: To evaluate the prevalence of halachic infertility in an ultra-Orthodox jewish community, and assess the efficacy of estradiol treatment in postponing ovulation and increasing pregnancy rates. METHODS: We reviewed 88 cycles, of which 23 were control cycles and 65 estradiol-treated cycles, and analyzed the files of 23 women who were treated with 6 mg estradiol/day from day 1 for 5 days of the cycle. RESULTS: The prevalence of precoital ovulation in the infertile population was 21%. Most of the patients (94%) ovulated before day 13 of the cycle. A short follicular phase due to low ovarian reserve orthyroid endocrinopathy was noted in 12% of the patients. While 64% of the women reported consultation with a Rabbinate authority, 68% of the patients sought medical therapy. Estradiol postponed ovulation for at least one day in 89% of the treatment cycles. Ovulation post-mikveh occurred in 73% of estradiol-treated cycles. The pregnancy rate was 12.5% per cycle and the cumulative pregnancy rate 35% per woman. Half the patients reported spotting during estradiol-treated cycles, and this postponed coitus. CONCLUSIONS: Precoital ovulation is a major reason for infertility among observant couples attending fertility clinics. Estradiol treatment is effective in delaying ovulation and restoring fecundity; however, it causes some adverse effects that may decrease its effectiveness. |
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Authors:
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Ronit Haimov-Kochman; Chana Adler; Eliana Ein-Mor; Daniel Rosenak; Arye Hurwitz |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Israel Medical Association journal : IMAJ Volume: 14 ISSN: 1565-1088 ISO Abbreviation: Isr. Med. Assoc. J. Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-06-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100930740 Medline TA: Isr Med Assoc J Country: Israel |
Other Details:
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Languages: eng Pagination: 100-3 Citation Subset: IM |
Affiliation:
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Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Mt. Scopus, Jerusalem, Israel. kochman@hadassah.org.il |
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