tailieunhanh - Case lâm sàng sản khoa - Case 10

Tham khảo tài liệu 'case lâm sàng sản khoa - case 10', y tế - sức khoẻ, y dược phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | CASE 28 A 31-year-old G1 Pl woman presents with a history of infertility of 2-yr duration. She states that her menses began at age 12 years and occurs at 28-day intervals. A biphasic basal body temperature chart is recorded. She denies sexually transmitted diseases and a hysterosal-pingogram shows patent tubes and a normal uterine cavity. Her husband is 34 years old and his semen analysis is normal. What is the most likely etiology 232 case FILES OBSTETRICS AND GYNECOLOGY ANSWERS TO CASE 28 Infertility Peritoneal Factor Summary An infertile couple is evaluated. Her menses are regular and a biphasic basal body temperature chart is recorded. She denies sexually transmitted diseases and a hysterosalpingogram shows patent tubes and a normal uterine cavity. The semen analysis is normal. Most likely etiology Endometriosis peritoneal factor . Analysis Objectives 1. Know the five basic etiologies of infertility. 2. Understand the history and laboratory tests for these five factors. 3. Understand that endometriosis is more common than cervical factor infertility. Considerations This 31-year-old woman has secondary infertility. In approaching infertility there are five basic factors to examine 1 ovulatory 2 uter-ine tubal 3 male factor 4 cervical factor and 5 peritoneal factor endometriosis . The patient has regular monthly menses. That by itself argues strongly for regular ovulation the biphasic basal body temperature chart is further evidence for regular ovulation. The uterus tubal factor is normal based on the normal hysterosalpingogram which is a radiologic study in which dye is placed into the uterine cavity via a transcervical catheter. The male factor is not an issue based on the normal semen analysis. Therefore the two remaining factors not addressed arc the cervical factor and peritoneal factor. If the patient had prior cryotherapy to the cervix the examiner might be directed to consider cervical factor similarly if the patient complained of the 3 Ds of .