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  #1  
Old 07-25-2012
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ObGyn Fertility Work Up; What's after Seminal Analysis!

infertility workup

what to do after ruling out male factor ? [ normal semen analysis]

endometrial biopsy or hysterosalpingogram ?
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  #2  
Old 07-25-2012
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endometrial biopsy to rule out anovulation...then comes HSG if ovulation is confirmed but infertility is still there
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Old 07-25-2012
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I have a query....sorry to post on your thread....when is FSH and progesterone level required in infertility or is it not?

Last edited by stfidel; 07-25-2012 at 03:30 PM.
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Old 07-27-2012
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so...i came across similar q in uworld...

A 26-year-old woman presents for evaluation of infertility. She describes her menstrual cycles as irregular
stating that they occur anywhere between 32 to 35 days. She has no galactorrhea. She eats a balanced diet
and exercises regularly. She has no other medical problems. Her BMI is 22 Kg/m2. Physical examination is
unremarkable. W hich of the following is the most appropriate initial test to evaluate her infertility?
A Endometrial biopsy
B. Hysterosalpingogram
C. Mid luteal serum progesterone level
D. Serum testosterone
E. Karyotyping


**
what is ans here? to my surprise and shock, it was not A as discussion went in this forum.
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Old 07-27-2012
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Quote:
Originally Posted by tyagee View Post
so...i came across similar q in uworld...

A 26-year-old woman presents for evaluation of infertility. She describes her menstrual cycles as irregular
stating that they occur anywhere between 32 to 35 days. She has no galactorrhea. She eats a balanced diet
and exercises regularly. She has no other medical problems. Her BMI is 22 Kg/m2. Physical examination is
unremarkable. W hich of the following is the most appropriate initial test to evaluate her infertility?
A Endometrial biopsy
B. Hysterosalpingogram
C. Mid luteal serum progesterone level
D. Serum testosterone
E. Karyotyping


**
what is ans here? to my surprise and shock, it was not A as discussion went in this forum.
Guess C, as initial test.
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Old 07-27-2012
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Quote:
Originally Posted by tyagee View Post
so...i came across similar q in uworld...

A 26-year-old woman presents for evaluation of infertility. She describes her menstrual cycles as irregular stating that they occur anywhere between 32 to 35 days. She has no galactorrhea. She eats a balanced diet and exercises regularly. She has no other medical problems. Her BMI is 22 Kg/m2. Physical examination is unremarkable. W hich of the following is the most appropriate initial test to evaluate her infertility?
A Endometrial biopsy
B. Hysterosalpingogram
C. Mid luteal serum progesterone level
D. Serum testosterone
E. Karyotyping
C. Mid luteal serum progesterone level

Quote:
Originally Posted by tyagee View Post
what is ans here? to my surprise and shock, it was not A as discussion went in this forum.
You have to understand that for step 2 there cannot be a single correct answer for a particular diagnosis (one test/treatment fits all) since the answer depends on the History/Exam findings/Test results etc,
For example, in the above question if you change the stem and keeping the answer choices same:
A is correct if the Q stem suggests endometrial pathology
B is correct if the Q stem suggests anatomical abnormality
C is correct if the Q stem suggests ovarian problem
D is correct if the Q stem suggests suggest PCOS
E is correct if the Q stem suggests Turner syndrome etc

All of them are just different steps in infertility workup and you have to pick the answer based on the information provided.
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Old 07-28-2012
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Quote:
Originally Posted by Novobiocin View Post
You have to understand that for step 2 there cannot be a single correct answer for a particular diagnosis (one test/treatment fits all) since the answer depends on the History/Exam findings/Test results etc,
For example, in the above question if you change the stem and keeping the answer choices same:
A is correct if the Q stem suggests endometrial pathology
B is correct if the Q stem suggests anatomical abnormality
C is correct if the Q stem suggests ovarian problem
D is correct if the Q stem suggests suggest PCOS
E is correct if the Q stem suggests Turner syndrome etc
novo , as per my know...isnt fertility workup very streamlined...,"first rule out male factor..then female factor starting with anovulation and then tubal causes.....
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Old 07-28-2012
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Quote:
Originally Posted by tyagee View Post
novo , as per my know...isnt fertility workup very streamlined...,"first rule out male factor..then female factor starting with anovulation and then tubal causes.....
Yes, we discussed it here

But the point I was making is that the answer depends on the info given in the question stem and there cannot be a single standard answer.
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