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Medical Academy named after S.I. Georgievsky

1.

Medical Academy named after S.I. Georgievsky
Department of obstetrics, gynecology and perinatology №1
CLASS № 15
Sterile marriage. Reproductive technologies.
CASE-TASK
Teacher
Asst. Puchkina Galina Anatolievna
Begin
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2.

History
Examination
Investigations
Hysterosalpingogram
Questions

3.

HISTORY
A 31-year-old woman and her 34-year-old partner are referred by the general practitioner
because of primary infertility. They have been trying to conceive for over 2 years. The
woman has regular menstrual periods bleeding for 4 days every 28–30 days. Her periods
are not heavy and have never been painful. There is no intermenstrual bleeding or discharge
and no postcoital bleeding. She has never been diagnosed with any sexually transmitted
infections.
The last smear was normal 1 year ago. She is a non-smoker and drinks alcohol very
occasionally.
The partner’s only previous medical history was an appendectomy and a course of antihelicobacter
therapy after he developed epigastric pain and was diagnosed with the infection.
He previously smoked 20 cigarettes per day and drank up to 28 units of alcohol per
week but has now stopped smoking and significantly reduced his alcohol intake. He works
as buyer for a retail company.
The couple have intercourse 1–4 times per week and there is no reported sexual dysfunction
or pain on intercourse. They both deny recreational drug use.
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4.

EXAMINATION
On examination the woman has a body mass index
of 23 kg/m2. There is no hirsutism or
acne. There are no signs of thyroid disease. The
abdomen is soft and non-tender.
Speculum and bimanual palpation are
unremarkable. Genital examination of the partner
is also normal.
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5.

INVESTIGATIONS
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6.

HYSTEROSALPINGOGRAM
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7.

QUESTIONS
• How do you interpret the investigation results?
• Are any further investigations necessary?
• How would you manage this couple?
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