Department of OB/GYN 5Aug06
MAMC Reproductive/Endocrinology and Infertility Service
Subject: General guidelines for referral of infertility/endocrinology services at MAMC
Infertility evaluation request with referral
1) Day 3 FSH/Estradiol Age > 35, or for any age with irregular menses w/o
diagnosis of PCOS
2) Prolactin
3) TSH
4) HSG or equivalent evaluation of tubal status (i.e. laparoscopy)
5) Semen analysis
6) Nutrition consultation for BMI >40 for weight loss prior to referral
7) Referral to specialty services for specific medical or surgical conditions requiring
consideration prior to implementing infertility treatments or subsequent
pregnancy (includes genetic counseling)
8) Folic acid supplementation
9) Immediate referral for all female patients >40 years of age interested in fertility or
any age with previous failure of in vitro fertilization at an outside institution
Reproductive endocrinology referral
1) Refer any patient with reproductive endocrine conditions (per provider’s
judgment)
a. Include developmental reproductive issues
i. Reproductive developmental delay
ii. Precocious reproductive development
b. Reproductive anatomic abnormality
i. Intersex conditions
ii. Abnormalities of sexual differentiation
The entire spectrum of infertility diagnosis and treatment are available through MAMC
including all advanced reproductive technologies. The infertility service is dedicated to
supporting strong families within the military health care system. While diagnostic
evaluation will be provided to all DOD eligible beneficiaries, initiation of treatment is
limited to married couples in stable relationships. In addition, the Madigan infertility
service is committed to the long term health of all patients and require any patients with a
BMI in excess of 40 to participate in a weight reduction program prior to initiation of
infertility treatment. We strongly encourage all patients (BMI 25-39) to actively engage
in a weight reduction/health maintenance program during or prior to infertility treatment.
Please contact Jackie Rice @ 968-3783 for any further questions and an appointment.
Gregory E. Chow
COL, MC
Chief, Reproductive Endocrinology & Infertility
Department of OB/GYN