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GPs' infertility test access backed

By Daniel Cressey

Giving GPs direct access to infertility tests has significant benefits for patients, results of a new pilot show.

An NHS-funded study of open-access hysterosalpingo-graphy found that couples reached a diagnosis and management plan four weeks earlier than those referred to specialists.

The researchers said that alongside semen analysis and endocrine blood tests, open

access hysterosalpingography would enable GPs to diagnose the cause of infertility and make more appropriate referrals.

Study leader Dr Scott Wilkes, a GP in Morpeth, Northumberland, and clinical research

fellow at the University of Sunderland, told Pulse that in-

volving GPs in the early

stages of infertility management was also likely to prove cost-effective.

He said: 'There are quite a few advantages. The infertile couple are engaged immediately with the process of investigation; they move through faster to the end point; patients are supported though the process of infertility management by their GP.'

He added: 'My feeling is infertility management will distil down into two areas [with] primary care taking up an increased role in the initial

management of the infertile couple.'

The pilot, published in Human Fertility (March), initially involved six GP surgeries but the open-access service has now been rolled out to a further 68 practices.

Dr Lindsay Smith, the RCGP maternity spokesperson, said: 'I certainly would agree with the general drift that appropriately trained GPs could deal with the investigation of infertility earlier, quicker and probably cheaper in primary care.'

She added that semen analysis, ovulation testing and hysterosalpingography were key to initial infertility testing. 'In the past GPs haven't had access to hysterosalpingography. That is the third part of the jigsaw.'

Dr Andrea Kingston, a GP in Milton Keynes with an interest in fertility, said: 'It would save consultants time. A lot of explanation and reassurance can be done in general practice as well as investigation'.

However Mr Anthony Ruth-erford, spokesperson for the Royal College of Obstetrics and Gynaecology and consultant in reproductive medicine at Leeds General Hosptial, warned that open access would have to come within an 'established framework'.

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