A good and accurate account of your medical history will help us in the diagnosis and treatment of your suspected fertility problem. This will save time and cost because there is no need to repeat the same tests or unsuccessful treatments that you had done before.
The detailed history that you need to provide our doctors and counselors include your past medical and surgical events, current health status, diet and lifestyle, occupational risks, history of sexual development, use of birth control, previous pregnancies or miscarriages and sexual practices.
The medical history will be collected by our doctors, embryologists, counselor or nurses.
Subsequent investigations will be done depending on the findings from the history and physical examination.
The following histories are relevant and should be volunteered during your consultation:
The average length of a normal menstrual cycle is 28 days. Menstrual cycle that is shorter than 21 days and longer than 35 days is considered as abnormal. Long menstrual cycle, ie every 2 to 3 months, or amenorrhea (no menses at all) implies failure of ovulation. In other words, there is no mature egg released from the ovary and there will not be fertilization by the sperm.
It is normal to have mild abdominal pain on the day before your menses come which is due to increase blood flow to the pelvic and fluid congestion. The accumulation of fluid in the pelvic will cause bloated tummy and mild abdominal pain.
The pain will disappear when your menses comes. Menses pain which occurs during your menstruation may be due to endometriosis (the growth of endometrial cells outside the uterus) because of the backward flow of blood into the pelvis.
Endometriosis bleeds in the pelvis during menstruation and cause irritation and pain. This pain will worsen when menstruation proceeds. Endometriosis may cause inflammation and formation of scar tissue. This scar tissue may block the Fallopian tubes or interfere with ovulation.
STDs such as gonorrhea and chlamydia will cause pelvic adhesion. Pelvic adhesion will eventually cause the pelvic organs to stick together causing blockage of Fallopian tubes, damage to the cilia (tiny hairs that help to ‘sweep’ the fertilised or unfertilised egg along the Fallopian tube and toward uterine cavity) in the Fallopian tubes and failure of transport of the egg into the Fallopian tube.
In the case of dysfunctional cilia, the fertilised egg cannot be ‘swept’ to the uterine cavity and remains at the ampula of the Fallopian tube. The fertilised egg will develop and implant in the ampula there leading to ectopic pregnancy. Ectopic pregnancy is life threatening to the woman and need to be surgically removed.
In rare cases of ruptured appendix, the infection will spread through the pelvic organs such as ovaries, fallopian tubes and uterus and cause scarring of tissue and adhesion. As mentioned above, the scarred tissue and pelvic adhesion will interfere with egg transport and ovulation.
A report of previous pelvic surgery will indicate the organs in the pelvis which were damaged and operated on. You can get your clinical or histopathological report from your previous surgeon.
If our doctor knows the nature of your previous pelvic surgery, then he will be able to diagnose your fertility early without further elaborated test. For example if your report indicates that you had your tubes removed during the surgery then your treatment of choice will be IVF. Previous pelvic surgery may also cause pelvic adhesion and interfere with ovulation.
Sexual problems such as vaginismus (disability of sexual penetration), vaginal dryness and dyspareunia (painful sexual intercourse) may lead to coitus failure or reduce the couples’ desire and frequency of sexual intercourse. Subsequently, your chance of getting pregnant is decreased.
This is important for you because we save time and cost by not repeating the same tests. Please bring along the following if you have:
- Hormone assay report/s
- Hysterosalpingogram (HSG) report
- Laparoscopy report
- Previous surgery report
The infection of STDs such as gonorrhea and chlamydia may cause the formation of pus cells in testis, vas deferens, bladder or urethra. These pus cells will decrease sperm motility and associate with male infertility. The infection may also lead to the formation of scar tissue and block sperm passage.
If mumps occurs in male after puberty and the viral infection will spreads to male reproductive organs and cause tissue damage associate with male infertility.
The viral infection may cause inflammatory in the testis, prostate, or urethra and affect sperm number and motility. It will also cause inflammation to the Parotid salivary gland noted a neck swelling below the earlobe.
Previous history of genital surgery such as testicular surgery or inguinal hernia repair may be associate with infertility. The surgery may injure the male reproductive organs such as vas deferens or testis and affect the sperm production or transportation from testis to urethra.
Sexual problems that affects male include erectile dysfunction (ED), premature ejaculation and retrograde ejaculation (backward flow of semen into bladder instead of urethra). These may lead to failure of coitus or sperm deposition into the vagina and is associates with infertility.
This is important for our doctors so that we need not to repeat the same test and save time and cost.
Please bring along the following if you have:
- Semen analysis report
- Previous surgical report