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Wednesday, June 12, 2013

Infertility Counseling

       Infertility Counseling
   For counseling session, the couples must come together. The followings are
     necessary interrogations during counseling.
·          Marriage duration (use of contraception)
·          Duration of infertility
·          Frequency & timing of intercourse    
  Physical fitness of husband
o      Weakness during intercourse, premature ejaculation, retrograde ejaculation
o      Past medical history (tuberculosis, mumps, STD etc.)
o      Surgical history
o      History of varicocoel/hydrocoel/hernia in male
o      Behavioral history of couple/stress factor
o      Social history
o      Occupational history
o      Food habit
o      Other habits
o      Smoking /drinking/drug
o      Habit of using tight underwear
 Physical fitness of wife
o      Age of woman   
o  Malnutrition

o      Obesity 
   Menstrual history 
o      Duration (regular, irregular) 
o      Bleeding pattern (normal, heavy or  scanty 
o      Painful menstruation (dysmenorrhoea), before, during & after period
 o      Breast pain before, during & after cycle 
o      Milk secretion 
o      Past obstetrical history /recurrent abortion 
    Past medical history 
o      Tuberculosis 
o      Sexually Transmitted Diseases (STD) 
o      Toxoplasm, Rubella, Chlamydia & Herpes (TORCH) infections 
o      Family history of infertility
o Food habit
o      Habits -Smoking /drinking/drugs
Any family torture due to infertility 
Surgical history
Behavioral history of couple/stress factor
 Social history 
  Occupational history 

NB: In counseling session, it is important to mention about the fertile days of the menstrual cycle. During counseling, the couple must be orientated about the possible causes of their infertility.  It is equally important to explain them about the type of investigations they need to carry out. They must be explained about the reasons why they need those tests.