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Chapter 1 Do you have an infertility problem ? When to Start Worrying! Chapter 2 How Babies are Made - The Basics Chapter 3 Finding Out What’s Wrong -- The Basic Medical Tests Chapter 4 Testing the Man - Semen Analysis. Chapter 5 Beyond the Semen Analysis Chapter 6 Diagnosis and Treatment for Male Infertility -- More Confusion ! Chapter 7 The Case of the Man with a Low Sperm Count. Chapter 8 Microinjection: The Latest Advance in Treating the Infertile Man. Chapter 9 Ultrasound - Seeing with Sound. Chapter 10 Laparoscopy -- The Kinder Cut Chapter 11 Hysteroscopy Chapter 12 The Tubal Connection Chapter 13 Ovulation -- Normal and Abnormal Chapter 14 The Older Woman Chapter 15 Polycystic Ovarian Disease (PCOD) Chapter 16 The Cervical Factor Chapter 17 Hirsutism -- Excess Facial and Body Hair Chapter 18 Endometriosis -- The Silent Invader Chapter 19 Ectopic Pregnancy – The Time Bomb in the Tube Chapter 20 Unexplained Infertility Chapter 21 Secondary Infertility -- Caught Between Fertile And Infertile Worlds Chapter 22 Empty Arms -- The Lonely Trauma of Miscarriage Chapter 23 Understanding Your Medicines Chapter 24 Intrauterine Insemination Chapter 25 Test Tube Babies - IVF & GIFT Chapter 26 PREIMPLANTATION GENETIC DIAGNOSIS - the newest ART Chapter 27 Using Donor Sperm Chapter 28 Surrogate Mothering Chapter 29 When Enough is Enough - The Decision to End Treatment Chapter 30 Adoption - Yours by Choice Chapter 31 Childfree living - Life without children Chapter 32 Stress And Infertility Chapter 33 The Emotional Crisis of Infertility Chapter 34 How to Cope with Infertility Chapter 35 Infertility and Sexuality Chapter 36 Support Groups-Self-Help is the Best Help Chapter 37 Myths and Misconceptions Chapter 38 Helping Hands - How Friends and Relatives can Help Chapter 39 RIGHTS OF THE INFERTILE COUPLE - AND WHAT SOCIETY NEEDS TO DO ABOUT THEM Chapter 40 Alternative Medicine: Exploring Your Treatment Options Chapter 41 Making Decisions about Treatment Chapter 42 How to Find the Best Doctor Chapter 43 How to Make the Most of Your Doctor Chapter 44 Let the reader beware - making sense of medical stories in the news Chapter 45 THE INFERTILE PATIENT'S GUIDE TO THE INTERNET Chapter 46 The Ethical Issues - Right or Wrong ? Chapter 47 How Much Does Treatment Cost? Chapter 48 Pregnant - At Last ! Chapter 49 Preventing Infertility Chapter 50 The Infertile Patient's Prayer and Infertility "Defined" Chapter 51 Making IVF affordable Chapter 52 Why are women scared of IVF ? Chapter 53 INFERTILITY RECORD SHEET Chapter 54 Self-Insemination |
INFERTILITY RECORD SHEET This form can be useful to summarise and record your infertility history; and is very useful when you need to seek a second opinion.
Date__________________ Name _____________________________________ Partner Name_______________________________ SOCIAL HISTORY How long have you been married?_____________ How long have you been trying to get pregnant? ________________ How long have you been trying to get pregnant with a doctor's help?_______________ Was it a General Gynecologist or an Infertility Specialist? _________ About how many times a month do you have intercourse? _____ Does either partner smoke? _____________ How much? ___________ Does either partner use recreational drugs? ________ Which ones? _____________________
FEMALE HISTORY Age____ Birthdate ________ Height_________ Weight__________ Menstrual periods occur every ________ days. Are they regular? __________ For how many days do you bleed? _________ Do you have endometriosis? __________ Have you ever had pelvic inflammatory disease (PID)? ________________________________ What pelvic surgeries have you had? _______________________________________________ What were the findings? _________________________________________________________ ____________________________________________________________________________ Number of pregnancies with this partner _______ Number of pregnancies with a previous partner _______ Number of miscarriages _______ Number of abortions __________ Number of tubal pregnancies ________ Number of live births _________ Medical problems and current medications of female partner: _______________________________ ________________________________________________________________________
MALE HISTORY Age____ Birthdate Number of pregnancies with a previous partner _______ Do you have problems with erection or ejaculation? _______________________________ Sperm count: ____________ million per ml. Motility ___________ % Male medical problems and current medications __________________________________________ ________________________________________________________________________
MEDICAL HISTORY Have you had:
Test Yes/No Date Result
Hysterosalpingogram
Laparoscopy
Hysteroscopy
Other
Treatment Yes/No How many Date Any success? Ultrasound monitoring Clomiphene stimulation with intercourse
Clomiphene stimulation with insemination
Injectable HMG stimulation with intercourse
Inseminations without any stimulation Injectable HMG stimulation with insemination
In vitro fertilization ( IVF)
ICSI Give details of IVF / ICSI results, if applicable. Stimulation Follicles Embryos Embryos Embryos protocol used grown formed transferred frozen
OTHER Are there other pertinent test results, procedures or problems that have been identified?
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