Written by Dr.M.D.Mazumdar, MD
An Infertility workup should be started after 1 year of unprotected regular sexual intercourse in couples in whom the female partner is less than 35 years and after 6 months in couples in whom the female partner is more than 35 years. But infertility workups can be started earlier in women who have a known risk for inferitly - such as endometriosis, irregular menstrual periods and a history of sexually transmitted diseases, especially chlamydia.
Infertility investigation requires probing into the minutest physical and psychological details. Management therefore needs sympathy, compassion and a great deal of tact on the part of the doctor.
It is necessary that the couple should be first spoken to together and then again separately. This is so that each is free to reveal anything they should wish to in complete confidentiality.
Knowing the details of the female reproductive organs, and how pregnancy occurs go a long way in understanding the different causes of infertility.
Clinical assessment and a thorough history should be taken before the couple is subjected to investigations, both invasive and non-invasive. Certain points are to be especially noted:
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The causes of female infertility are very different from the causes of male infertility and require different types of tests for an accurate diagnosis.
The treatment procedures of the male as well as the female partner are also different.
The aim of treatment is to remove any of the identified factors causing infertility. Most couples appreciate a description of the physiological process of fertilization and conception.
A sympathetic response to their difficulties goes a long way in decreasing the stress involved in visiting a doctor for treatment.
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