history taking in infertility by dr. gayathiri

22
HISTORY TAKING IN INFERTILITY Dr. Gayathiri Ganesan Ram MS(O.G), Fellow in Reproductive Medicine and Andrology Consultant Infertility Specialist ARC Fertility Centre

Upload: morris-jawahar

Post on 21-Apr-2017

10 views

Category:

Healthcare


2 download

TRANSCRIPT

Page 1: History taking in infertility by Dr. Gayathiri

HISTORY TAKING IN INFERTILITY

Dr. Gayathiri Ganesan RamMS(O.G), Fellow in Reproductive Medicine and Andrology

Consultant Infertility SpecialistARC Fertility Centre

Page 2: History taking in infertility by Dr. Gayathiri

Failure to conceive within 1 year of regular unprotected coitus.

WHAT IS INFERTILITY?

Page 3: History taking in infertility by Dr. Gayathiri

Primary – patients who have never conceived.

Secondary – previous pregnancy achieved but failure to conceive subsequently.

WHAT ARE THE TYPES?

Page 4: History taking in infertility by Dr. Gayathiri

80% couple achieve pregnancy in 1 year.

Another 10% achieve by end of 2nd year.

Another 10% remain infertile by end of 2nd year.

INCIDENCE

Page 5: History taking in infertility by Dr. Gayathiri

NAME - Identification

AGE- young/ elder.

EDUCATION – IQ level.

OCCUPATION – Stress level/ type of work/ Exposure to toxins/ associated to obesity.

FEMALE PARTNER

Page 6: History taking in infertility by Dr. Gayathiri

MENSTRUAL HISTORY Menarche – attained or not? Age – early or late? Regularity- RMC or IRMC? Flow – less or more? Associated with clots? Duration of cycle? Dysmenorrhea?

Page 7: History taking in infertility by Dr. Gayathiri

MARITAL HISTORY Duration of marriage? Consangity – I / II/ III / NCM ? Cohabitation How long are they trying for? Contraceptives?

Page 8: History taking in infertility by Dr. Gayathiri

SEXUAL HISTORY Frequency – adequacy? H/O dysparunea? Pain at the beginning or end of act? H/O semen coming out immedietely? Satisfactory or not? H/O lubricants? Other issues like burning or irritation?

Page 9: History taking in infertility by Dr. Gayathiri

OBSTETRIC HISTORY Para Type of conception? Previous deliveries. Mode/ indication. Full term or not? Abortions/ which trimester? D&C? Incompetence/ Sterilization?

Page 10: History taking in infertility by Dr. Gayathiri

PAST MEDICAL HISTORY BP – recent or long term. DM- drugs / OHA / Insulin. PT – tubal issues. BA – seasonal or regular/ steroid. Epilepsy – drugs Thyroid Heart disease – type/ compensated or

not? Mumps (tubal)

Page 11: History taking in infertility by Dr. Gayathiri

PAST SURGICAL HISTORY D’Lap – Indication. CPT. LOD? Myomas Cystectomy Resection? Hysteroscopy Sterilization? Appendicectomy Salphingectomy Other laps?

Page 12: History taking in infertility by Dr. Gayathiri

PAST MEDICAL HISTORY Previous treatment? IUI – drugs used? ICSI details.

Page 13: History taking in infertility by Dr. Gayathiri

CURRENT MEDICATION Thyroid correction Glycemic control PCOD – metformin Prolactin Heart problem – digoxin BA – neb/ puff

Page 14: History taking in infertility by Dr. Gayathiri

FAMILY HISTORY Infertility CA DM HT Siblings Age of menopause of sister/ mother

(pof)

Page 15: History taking in infertility by Dr. Gayathiri

NAME – Identity.

AGE – young/elder.

EDUCATION

MALE PARTNER

Page 16: History taking in infertility by Dr. Gayathiri

OCCUPATION Type of work Heavy or light work Hours Exposure to toxins

Page 17: History taking in infertility by Dr. Gayathiri

H/O TRAUMA Type Age Surgery Testis affected?

Page 18: History taking in infertility by Dr. Gayathiri

PAST MEDICAL HISTORY DM HT Psycosis TB (Orcitis) BA (antihistamines/ steriods) Epilepsy (drugs) Gastritis (antacids) Thyroid STI Testosterones and adjuvants

Page 19: History taking in infertility by Dr. Gayathiri

PAST SURGICAL HISTORY Hydrocele Hernia Orchidectomy Testicular biopsy Appendix Chole

Page 20: History taking in infertility by Dr. Gayathiri

FAMILY HISTORY HT DM CA Infertility Siblings

Page 21: History taking in infertility by Dr. Gayathiri

PERSONAL HISTORY Smoking Alcohol Substance abuse Diet

Page 22: History taking in infertility by Dr. Gayathiri

SEXUAL HISTORY Frequency Erection Ejaculation H/O lubrication