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Treatment algorithm for infertile couples with oligo-anovulation. This reduces the amount of circulating androgens and promotes ovulation induction.
The patient should be asked about dyspareunia or severe dysmenorrhea that may be linked to endometriosis. With gentle traction on the cervix, a small amount of radiopaque dye is instilled in the uterine cavity under fluoroscopic control. Preovulatory transvaginal sector sonography is a highly useful tool for evaluating adequate follicle development, endometrial assessment and oocyte release. To foreclose on real property, the plaintiff must be able to establish the chain of title entitling it to relief. Additional dye is instilled to check for patency of fallopian tubes.
Cervical traction is often necessary to completely evaluate the uterine cavity. Life-tablele analysis studies demonstrate a longer period of time to conception for smokers as compared to nonsmokers. The more recent cases, however, are looking at something more serious. There is great variation from sample to sample in terms of volume, number, and motility. This can be overcome by the use of silicon condoms, which allow the man to produce a semen sample by intercourse.
If previous pelvic surgery has been performed, operative notes, photographs, or videotapes should be obtained and reviewed. During this time a semen analysis is also obtained. Evaluation of the Couple as a Unit Infertility should be regarded as a two-patient disorder.
Cigarette smoking has also been implicated in subfertility. The presence of acne, oily skin, and hirsutism indicates androgen excess. The endometrial biopsy may also be used to confirm ovulation and diagnose a luteal phase defect. The prostate should be evaluated for size and evidence of prostatitis. Previous pregnancies, abortions, and birth control history are also documented.
Diagnostic algorithm for the basic evaluation of the infertile couple. Any attempt to transfer the beneficial interest of a trust deed without ownership of the underlying note is void under California law. All medications used by the couple should also be reviewed.
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