Chapter 39: Medical Risks of Infertility

This chapter describes infertility as associated with diseases that affect both a woman's fertility and her general health, a pattern the author calls a "two-pronged" effect. The chapter reviews reported associations between conditions such as endometriosis, polycystic ovarian disease and pelvic adhesive disease and pelvic pain, bowel symptoms, metabolic disturbance, ovarian, endometrial and breast cancer, osteoporosis, immune alterations and complications in later pregnancies. Hilgers presents Pope Paul VI Institute data showing lower post-Peak progesterone levels in women with infertility and regular cycles than in controls, and higher androgen levels in women with polycystic ovarian disease. The chapter criticizes insurance exclusions of "fertility-related services" as unevenly applied and as targeting women, and cites a study estimating the added cost of infertility evaluation and treatment at $0.67 per member per month.