• Fertility
  • Ability to conceive
• Infertility
  • Inability to conceive after one year of unprotected intercourse
• Disease of couples, not individuals
• Feelings of guilt
• Where to go for information?
• Feelings of frustration and anger
• occupation                          
• Medical Drugs
• Smoker
• Prolonged fever, infections
• Radiation
• Spinal cord injury
• Depression
• Dysuria, urethral discharge
• Previous surgeries(groin,herniorapphy,vasectomy)

Female evaluation

• Menstrual cycle regular /irregular
• Vaginal discharge (leucorrhea)
• Dysmenorrhea (menses pain)
• Post coital (after sex) bleeding
• Inter menstrual (in between) bleeding
• Weight gain
• Hirsutism (excessive hair)
• Headache
• Visual disturbance
• Galactorrhea(breast discharge/milk)
• Cold and heat intolerance
• Abdominal mass
• Medical history
  • Diabetes
  • TB,
  • radiation,
  • chemo therapy,
  • genetic disorders
  • pelvic inflammatory disease
• Drug history
• Any previous surgery
• Pelvic surgery (fibroid, ovarian cyst , previous cesareans )
• Appendix

Examination

Weight & examination related to above mentioned points in history is important. Local pelvic examination for pelvic pathology.

Investigations

Base line test according to history & examination

Focus will be on

• Laparoscopy
• Hysteroscopy

Treatment

Infertility treatment is given according to the work up .

It includes

• Ovulation induction
• Surgical treatment
• Male factor treatment
• IUI
• Associated factors treatment
• Consultations for ART (IVF, ICSI, PGD)