Written by Dr.M.D.Mazumdar, MD
The Basic Infertility Workup includes physical examinations and medical and sexual histories of both partners. A thorough infertility workup of the couple should be done before any tests are carried out. Tests may be both invasive and non-invasive.
The couple should be asked about their age, previous pregnancies, if any, frequency of intercourse, pain during intercourse and whether they use any lubricants during sex. Use of birth control methods, menstrual history, current and past sexual practices, surgical history and other health issues should be discussed. The history may sometimes suggest the cause of the infertility.
Details about any relevant medical diseases that they may suffer from (like diabetes, thyroid hormone deficiency) and whether they take any medicines, either as recreational drugs or for any diseases should be enquired about.
The most important factors controlling pregnancy in a woman are patency of the reproductive tract, mainly the tubes, and regular ovulation or anovulation.
The advantage of an HSG is that not only does it reveal whether a block is present or not, it also reveals the position of the block in the reproductive tract, and also the presence of adhesions around the tubes.
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The temperature is recorded from the 1st day of the menstrual cycle. The oral temperature should be taken first thing in the morning while the woman is still in bed, before taking any food or even rinsing the mouth. There may be a sharp drop of about 0.5 degrees just at the time of ovulation. Then the temperature rises and stays more than 1 degree above the pre-ovulation temperature. If pregnancy occurs, it continues to remain high throughout pregnancy. But if pregnancy does not occur, it begins to drop again 2-3 days before the start of the next menstrual cycle.
The BBT can be altered by lack of sleep, stress or fever. It is not very reliable in women with irregular cycles. But its advantage is that it can be done by the couple themselves in the privacy of their home.
The BBT is the basis of the rhythm method of birth control.
Conditions like Asherman's Syndrome and Sheehan's Syndrome can not only cause infertility but also loss of periods ( Amenorrhea).
Tests for the diagnosis of any cause of infertility of the male partner should be carried out simultaneously with tests for female infertility.
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