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History taking > Common gynae histories - infertility > Flashcards

Common gynae histories - infertility Flashcards

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1
Q

What areas would you want to ask about for a couple presenting with subfertility?

A
  • General - when they started trying
  • Coitus
  • Partners - consider each partner
  • Women’s gynaecological health
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2
Q

What would you want to ask about coitus in a couple with subfertility?

A
  • FRequency
  • Difficulties
  • Relation to fertile days
  • Pain
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3
Q

What would you want to ask about each individual partner in a couple with subfertility?

A
  • Age
  • Accupation
  • BMI
  • Previous children - same/different partner
  • Smoking and alcohol
  • Current medications
  • Mans PMHx
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4
Q

What features of subfertility would suggest PCOS as a cause?

A
  • Acne
  • Hirsuitism
  • Secondary amenorrhoea
  • Obesity
  • Diabetes
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5
Q

What features associated with subfertility suggest fallopian tube damage?

A
  • History of STI’s
  • PID
  • Pelvic surgery
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6
Q

What features associated with subfertility suggest endometriosis?

A
  • Cyclical pelvic pain
  • Dysmenorrhoea
  • Deep dyspareunia
  • Menstrual disturbance
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7
Q

What features associated with subfertility suggest a cervical obstruction (e.g. stenosis, hostile mucus, polyp, inflammation)?

A
  • Previous cervical surgery
  • Current STI symptoms
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8
Q

What features associated with subfertility suggest hyperprolactinaemia?

A
  • Use of anti-psychotics
  • Visual symptoms
  • Galactorrhoea
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9
Q

What features associated with subfertility suggest hypothalamic disturbance (e.g. anorexia, stress, athletes)?

A
  • Extreme anxiety, stress or exertion
  • Poor diet
  • Extreme efforts to lose weight/weight loss
  • Low BMI
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10
Q

What questions would you ask about womens gynae health in someone having problems with subfertility?

A
  • Gynae questions - discharge, pain, PV bleeding
  • PCOS symptoms - hirsuitism, greasy skin, obesity
  • Prolactinoma - galactorrhoea
  • PMH - STIs, pelvic operations
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11
Q

What female problems can cause subferitlity?

A
  • PCOS
  • Endometriosis
  • Fallopian tube damage
  • Cervical barrier
  • Hyperprolactinaemia
  • Hypothalamic disturbances
  • Hypogonadotrophic hypogonadism
  • Hypergonadotrophic hypogonadism
  • Congenital uterine/vaginal malformation
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12
Q

What are male causes of subfertility?

A
  • Hypogonadotrophic hypogonadism
  • Hypergonadotrophic hypogonadism
  • Varicocele
  • Anti-sperm antibodies
  • Abscence/blockage
  • Anatomical defects
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13
Q

What are coital difficulties which can cause subfertility?

A
  • Mechanical problems
  • ED
  • Timing
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