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Counselling the Infertile Couple

Dr Aniruddha Malpani
Dr Anjali Malpani
Mumbai, India

Dr Aniruddha Malpani is a member of the Obstetrics and Gynaecology Communications editorial board. He and Dr Anjali Malpani run the Malpani Infertility Clinic in Mumbai.  



Key Points

  • Counselling infertile patients is an increasing part of gynae-cological practice today, even in generalist clinics.

  • A systematic approach to management beginning with an appropriate diagnostic 'work-up' for the couple is indicated.

  • Infertility causes significant emotional distress, requiring empathetic management and, in some cases, referral to a mental health counsellor.

  • Patients should be encouraged to obtain relevant information in order to be actively involved in treatment decisions.

  • Infertility support groups and Internet material are additional resources available to the infertile couple.

 


Table 1. Sugessted diagnostic work-up for the infertile couple

1. Semen analysis
2. Measurement of gonadotrophins (FSH, LH), TSH, and prolactin (on day 3*)
3. Hysterosalpingogram (on day 8-9*)
4. Ovulation monitoring (vaginal ultrasound scans)
5. Measurement of progesterone level (on day 21*)
6. Diagnostic multiple puncture laparoscopy

 
*Day of menstrual cycle (day 1 = 1st day of menstrual bleeding).
Abbreviations: FSH = follicle stimulating hormone; LH = leutinising hormone; TSH = thyroid-stimulating hormone.



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