Infertility is a huge issue in women’s health and with proper diagnosis and treatment, positive outcomes can occur with diminished complications. Infertility is defined as a couple’s inability to conceive after 12 months of regular intercourse without use of contraceptives in woman less than 35 years of age (Fertility and Sterility, 2008). There are 2 types of infertility primary where no pregnancy has occurred or secondary where there has been a pregnancy (Fertility and Sterility, 2008). The patient’s general health status as well as their past medical history plays an important role in the chosen course of treatment.
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Questions about your regular health as well as past illness will be asked, especially age of menarche, regularity, occurrence, and flow of your menstrual period. The provider will ask if you ever had any, pelvic pain, anomalous vaginal bleeding or discharge, trauma, and any history of pelvic infection, especially sexually transmitted diseases (STD). Expect to be asked about prior pregnancies, miscarriages, surgeries, and types of contraception. The partner will be asked all of the same questions but if it’s a male questions concerning prior genital injury, surgery, infections, drug and/or medication use, history of fathering other children. A though physical is preformed before any testing to make sure there is not a physical component of the infertility problem. After the hands on physical is preformed and its negative for any abnormalities, testing then precedes to laboratory testing, hysterosalpingography to test patency of fallopian tubes and uterus. The male partner will have a semen analysis done to determine a count and mobility of the sperm. If abnormal a urology consults maybe in order for further …show more content…
It could range from medications to surgery depending on what the provider prefers. Initial labs would consist of a CBC, FSH and estrogen levels, TSH, prolactin, and Free T4(Fertility,2013). A pelvic ultrasound could be ordered to check for any anomalies. Genetic testing will be ordered depending on family history. HIV testing as well as Hepatitis B and C panels should be checked. HgA1c to determine if patient is diabetic relating to PCOS. Sexually transmitted disease should also be tested. Depending on testing results, further testing will be ordered, possible even surgery.
If simple changes and lifestyle modifications are unsuccessful and the couple returns after a year’s time and still not pregnant, advanced treatment options will be addressed. Further testing maybe needed to make sure that eggs are being produced and ovulation occurs every month. Clomid maybe started to induce ovulation. Metformin may also be tried as a first line treatment, or in combination of the two. A hysteroscopy which is the GOLD standard maybe preformed to visualize the uterus looking for