6.

INFERTILITY
0 1 2
1 Introduction to the patient + Consent
2 Age and body weight
3 Cc and duration
4 Primary vs Secondary (Have you ever been pregnant?)
5 If secondary, has it occur outside current partnership?
6 Asks whether she knows about her fertile period
7 Asks whether she use contraception
8 Galactorhoea; visual disturbance; Cold intolerance; constipation;
weight gain etc
9 History of ectopic pregnancy
10 History of PID, endometriosis
11 History of pelvic surgery
12 Asks Whether she has an eating disorder (Anorexia nervosa)
13 Sexual history: frequency, at time of involution
14 PGYNHx: Menstrual history ( LMP, regularity, dysmenorrhea,
intermenstrual bleeding)
15 PMHx: Fibroids, DM, thyroid problem, HTN
16 RxHx: NSAIDs; anti- hypertensive , anti-androgen
17 FMHx: Similar condition in the family
18 SHx: smoking , alcohol , illicit drug user, stress , excessive exercise
19 Thanks patient

DDx: 1. Anovulation (Prolactinoma/hypothyroidism);

2. Male factor;
3. Tubal (PID/Adhesions).
INVESTIGATIONS: 1. Sperm analysis
2. BBT=flat, Prog= Low, Endo Biop=Proliferative; TFT; Serum prl
3. Hysterosalpingogram; laparoscopy