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October 11, 1995

A Couple With Infertility

JAMA. 1995;274(14):1159-1164. doi:10.1001/jama.1995.03530140071035

Dr Daley  : Mrs B is a 32-year-old paralegal. Married for 5 years to Mr B, a 32-year-old manager, they have been trying to conceive since 1992. They are both members of a health maintenance organization and live in Massachusetts, where health insurance coverage of infertility and advanced reproductive technologies is mandated by the state.In good health, Mrs B has never been pregnant and used oral contraceptives for 4 years before attempting pregnancy. Her menarche was at 12 years of age, with her cycles occurring every 28 days, lasting 4 days, with spotting between day 22 and day 25. In July 1993, after 1 year of attempting to conceive, the patient was referred by her primary physician to an infertility specialist. Mrs and Mr B then sought care from Dr T, another infertility specialist. Mrs B's past medical history is unremarkable except for a family history of fibrocystic breast disease.

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