Objectives: To determine the throughput of infertility patients in the gynaecology clinics at the Queen Elizabeth Hospital, Barbados as the lone public referral centre, and to determine whether these cases are being investigated and treated appropriately.
Methods: We reviewed all notes available prior to gynaecology clinics between February and April 2014. Using the NICE 2013 Fertility guideline as our standard, we collected data on clinical evaluation, advice, investigation and management of those patients with infertility. Upon completion of the study period, the data was reviewed and analysed.
Results: 79 of 1492 notes were fertility related – a 5.4% prevalence. 61.3% had secondary infertility, while 37% had primary. Most (31%) had an infertility duration of 1 year. Anovulation (32.3%) was the most common individual cause. The average female age was 30.9±6.6. Very few individual audit items approached 100%, suggesting room for improvement. 56.4% of patients might have benefitted from a tertiary care referral.
Conclusion: Fertility related referrals represent the fifth-most common problem seen in the gynaecology outpatients department. The majority of these have secondary infertility, and anovulation is the most common diagnosis. Male evaluation is lacking due mainly to non-attendance. Improvement in our practice might be facilitated through education on the guidance available.
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