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  #1  
Old 09-19-2012
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Default Cause of infertility

A 28-year-old woman and her husband present
to her obstetrician. They have been married for
7 years and have been trying to become pregnant
for the past 2 years. Prior to this the
woman used an intrauterine device for contraception,
which she had in place for 5 years.
Both are healthy without any medical problems,
and both deny a history of sexually transmitted
diseases. The woman states that her
menstrual cycles have always been regular (every
28 days, lasting for 5 days) since she was 14
years old. She also denies menorrhagia and
dysmenorrhea. Which of the following is the
most likely cause of this couple’s infertility?

(A) Endometriosis
(B) Low sperm concentration
(C) Pelvic infl ammatory disease
(D) Premature ovarian failure
(E) Prior placement of an intrauterine device
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  #2  
Old 09-19-2012
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Well if she is fine, young and healthy than that's the husband's problem...

B?
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Old 09-19-2012
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would go for C...not sure though
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Old 09-20-2012
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B

Due to social stigma we tend to blame infertility on women, however men have their fine share of incapacity to reproduce..

According to Uworld and MTB, the workup of infertility STARTS by blaming the male sex, you start by measuring sperm count and metabolic properties, if everything is normal then you move to the woman and if everything is normal you chill and hope for the best

2 out of every 3 couples will become pregnant in 3 years following the workup.

So for now ill blame the dude..

Also 5 years for a IUD i think is ok..
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Old 09-20-2012
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Quote:
Originally Posted by K06100 View Post
A 28-year-old woman and her husband present
to her obstetrician. They have been married for
7 years and have been trying to become pregnant
for the past 2 years. Prior to this the
woman used an intrauterine device for contraception,
which she had in place for 5 years.
Both are healthy without any medical problems,
and both deny a history of sexually transmitted
diseases. The woman states that her
menstrual cycles have always been regular (every
28 days, lasting for 5 days) since she was 14
years old. She also denies menorrhagia and
dysmenorrhea. Which of the following is the
most likely cause of this couple’s infertility?

(A) Endometriosis
(B) Low sperm concentration
(C) Pelvic infl ammatory disease
(D) Premature ovarian failure
(E) Prior placement of an intrauterine device
The lady has no syptoms or signs suggestive of the listed options, so B would be more appropriate
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  #6  
Old 09-20-2012
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Answer B .most common cause of infertility is the dude's problem
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Old 09-20-2012
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I would go for C ..pelvic inflamatory disease
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Old 09-20-2012
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Husband is shooting blanks.
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  #9  
Old 09-20-2012
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The correct answer is B. Infertility can be
caused by male or female factors. One-third of
cases are exclusively due to female factors, 20%
are exclusively due to male factors, and another
20% are due to a combination of female
and male factors. Given this wife’s unremarkable
past medical history, female factors are
less likely to be the cause of the couple’s infertility.
She has no symptoms of endometriosis,
no history of PID or STDs, and appears to have
properly functioning ovaries. Of the choices
listed, a male factor is the most likely cause of
this couple’s infertility. The most common
male factors include low semen volume, low
sperm concentration, decreased sperm motility,
and atypical sperm morphology.
Answer A is incorrect. Endometriosis is a common
cause of female infertility, as a result of the
pelvic adhesions that form from the ectopic endometrial
tissue. However, this patient has none
of the classic symptoms, such as severe dysmenorrhea
and chronic pelvic pain that result from
the adhesions. Hence, endometriosis is unlikely
to be the cause of this couple’s infertility.
Answer C is incorrect. PID is caused by ascending
infection of the female genital tract,
and is commonly associated with Chlamydia
trachomatis and Neisseria gonorrhoeae. It is a
common cause of female infertility secondary
to tubal occlusion. However, this patient has
neither a history of STDs nor symptoms such
as lower abdominal pain, vaginal discharge,
low back pain, fever, nausea, and vomiting. As
a result, PID is an unlikely cause of this couple’s
infertility.
Answer D is incorrect. A patient with premature
ovarian failure would present with early
amenorrhea (usually in her 30s) and premature
symptoms of menopause. Given the regularity
of this woman’s cycles, premature ovarian
failure is unlikely.
Answer E is incorrect. Intrauterine devices
are associated with an increased risk of STDs,
but there is no indication of prior STDs in this
woman. These devices are not associated with
subsequent infertility in the absence of prior
STD infection. This patient has no prior history
of STDs or current symptoms, such as
pelvic pain and abnormal vaginal discharge.
STDs can lead to infertility as a result of tubal
occlusion
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