HISTORY TAKING

PRESENTING COMPLAINT:

Duration of infertility, primary or secondary infertility, whether staying together and how long?,any difficulty during intercourse, incidents of separation through work or marital break up.

ASSOCIATED COMPLAINTS:

Discharge from the nipple, abnormal vaginal discharge, lower abdominal pain.

MENSTRUAL HISTORY:

Age of menarche, regular periods or not, frequency and no.of days of flow, premenstrual syndrome and dysmenorrhea, last menstrual period.

MARITAL AND SEXUAL HISTORY:

Whether the marriage has been consummated, frequency of coitus, knowledge of fertile period, superficial dyspareunia, deep dyspareunia, vaginismus, erectile or ejaculatory dysfunction of male, history of use if intrauterine device, history of any hormonal contraception like Depo provera which may cause delay in return of fertility, use of combined OCPs, previous marriage and fertility.

OBSTETRIC HISTORY(IN SECONDARY INFERTILITY)

If parous, type of delivery, antenatal complications and puerperal sepsis, secondary PPH  and failure of lactation indicates SHEEHAN syndrome, previous miscarriages, ectopic or molar pregnancy, previous induced or septic abortions.

PREVIOUS MEDICAL AND SURGICAL HISTORY

Previous PID/sexually transmitted diseases and treatment for the same, symptoms of hypothyroidism or hyperthyroidism, history of diabetes and thyroid disease, drug history-cytotoxic drugs,steroids,phenothiazines,tricyclicantidepressants,methydopa and metoclopramide, details of drug history like teratogenics, history of pelvic surgeries like myomectomy, ovarian cystectomy, laparoscopic ovarian drilling, conservative surgeries like endometriosis and tubal surgery, previous curettage can lead to asherman syndrome, ruptured appendix and tuberculosis may suggest tubal damage. But do consult the Best Gynecologist in Chennai for in-depth review of the condition.

PERSONAL HISTORY

Extreme exercise, weight loss, stress and psychogenic causes can result in amenorrhea, stress can result in infertility, effect of infertility on the couple, including grief, stress, psychosexual problems.

FAMILY HISTORY

Birth defects, mental retardation, infertility and premature menopause

HISTORY OF MALE PARTNER

OCCUPATION :Environmental hazards such as heavy metals and pesticides, high temperature due to occupational hazards or tight underclothing.

SEXUAL HISTORY:  Problems with intercourse premature ejaculation/retrograde ejaculation/loss of libido/erectile dysfunction

PERSONAL HISTORY: smoking and alcohol and drug consumption

MEDICAL HISTORY: history of high fever in the last 2 months can suppress sperm count, history of infections like mumps orchitis, tuberculosis or filariasis or epididymitis, previous sexually transmitted infections, usage of antipsychotic drugs may lead to erectile dysfunction, bronchiectasis in immotile cilia syndrome and young syndrome, renal and liver failure.

SURGICAL HISTORY: Undescended testis if not corrected by 2 years can lead to sterility and a risk of malignancy, testicular trauma and  torsion testis, history of hernia repair, vasectomy, lumbar sympathectomy and varicocoele surgery,

DRUG HISTORY:  drugs such as cytotoxic drugs, hormones, cimetidine and spironolactone may depress the sperm count.

SEMEN ANALYSIS: The best specimen obtained by masturbation in the vicinity of the laboratory. The best specimen will be produced if a short period of abstinence of 3-5 days. A more prolonged period of abstinence does not yield better results. The semen should coagulate soon after ejaculation due to enzyme in the seminal vesicle, but liquefy in 30min because of prostate enzyme. The semen is greyish in colour.

If you need any clarifications regarding the above cases, do visit the Best Fertility Hospital in Chennai for further counseling and medication.

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