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

Failure to conceive within 1 year of regular unprotected coitus.

WHAT IS INFERTILITY?

Primary – patients who have never conceived.

Secondary – previous pregnancy achieved but failure to conceive subsequently.

WHAT ARE THE TYPES?

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

NAME - Identification

AGE- young/ elder.

EDUCATION – IQ level.

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

FEMALE PARTNER

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?

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

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?

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

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)

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

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

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

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

(pof)

NAME – Identity.

AGE – young/elder.

EDUCATION

MALE PARTNER

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

H/O TRAUMA Type Age Surgery Testis affected?

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

PAST SURGICAL HISTORY Hydrocele Hernia Orchidectomy Testicular biopsy Appendix Chole

FAMILY HISTORY HT DM CA Infertility Siblings

PERSONAL HISTORY Smoking Alcohol Substance abuse Diet

SEXUAL HISTORY Frequency Erection Ejaculation H/O lubrication