Infertility: Diagnosis and Evaluation: Difference between revisions

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 === History ===
-* '''<span style="color:#ff0000">Risk factors'''
+* '''Infertility history'''
+** '''Duration of infertility'''
+** '''Whether the infertility is primary or secondary'''
+***Evaluation of men with secondary infertility should include a focus on conditions or exposures that have developed or occurred after initiation of the earlier pregnancy(ies).
+** '''Any treatments to date'''
+*'''<span style="color:#ff0000">Risk factors'''
 ** See [[Infertility: Epidemiology and Etiology|Epidemiology and Risk Factors for Infertility]] Chapter Notes
 ***'''<span style="color:#ff0000">Classification</span>'''
@@ Line 96: / Line 101: @@
 ****'''<span style="color:#ff0000">Testicular (TIC)</span>'''
 *****'''<span style="color:#ff0000">Toxins</span>''' (medications, chemotherapy, radiation, social habits)
-*****'''<span style="color:#ff0000">Infections</span>''' of the GU tract
+******'''If there has been exposure to any gonadotoxic agents, these medications should be stopped and semen should be retested in 3-6 months'''
+******'''Environmental exposures''' (pesticides, excessive heat on the testicles)
+****** '''Lifestyle''' (cigarette smoking, recreational drugs, alcohol use, stress, anabolic steroid usel)
+*****'''<span style="color:#ff0000">Infections/inflammation</span>''' of the GU tract (sexually transmitted infections, epididymo-orchitis, mumps orchitis)
 *****'''<span style="color:#ff0000">Childhood</span>''' (congenital causes (recall '''DUNKY-XX'''), hydrocele or hernia surgery, torsion, cryptorchidism)
 ****'''<span style="color:#ff0000">Post-testicular</span>'''
-*****'''<span style="color:#ff0000">Sexual history</span>''' (lubricants)
+*****'''<span style="color:#ff0000">Sexual history</span>'''
-* '''Infertility history'''
+******'''Libido, sexual function, sexual activity'''
-** Duration of infertility
+******Use of lubricants
-** Whether the infertility is primary or secondary
+* '''General health'''
-***Evaluation of men with secondary infertility should include a focus on conditions or exposures that have developed or occurred after initiation of the earlier pregnancy(ies).
+** '''Medical comorbidities (e.g., hypertension, hyperlipidemia, obesity, diabetes) can contribute to infertility.'''
-** Any treatments to date
-** Libido, sexual function, sexual activity
-* '''General health of the male''' (diabetes, respiratory issues, recent illnesses)
-** Medical comorbidities (e.g., hypertension, hyperlipidemia, obesity, diabetes) that can contribute to infertility.
 ** '''If there has been a recent serious medical illness or injury or evidence of a recent reproductive tract infection, semen testing should be repeated at least 3 months following recovery from the illness'''
-* '''Surgery of the reproductive tract''': testis cancer, undescended testis, hydrocelectomies, spermatocelectomies, varicocelectomies, vasectomies
+* '''Previous surgery of the reproductive tract'''
+**For testis cancer, undescended testis, hydrocelectomies, spermatocelectomies, varicocelectomies, vasectomies
 ** Vasectomy reversal may represent a more cost-effective option compared to IVF in couples with adequate ovarian function'''§'''
-* '''Proven or suspected GU infections/inflammation:''' sexually transmitted infections, epididymo-orchitis, mumps orchitis
-* '''Medications and therapies which might have an adverse impact on spermatogenesis'''
-** '''See [[Infertility: Epidemiology and Etiology|Epidemiology and Etiology of Infertility]] Chapter Notes'''
-** '''If there has been exposure to any gonadotoxic agents, these medications should be stopped and semen should be retested in 3-6 months'''
-* '''Environmental exposures''' (pesticides, excessive heat on the testicles)
-* '''Lifestyle''' (cigarette smoking, recreational drugs, alcohol use, stress, anabolic steroid usel)
 * '''History of any genetic abnormalities in the patient or the family'''