O&G: Fertility

Question 1

A 34-year-old lady attends a fertility clinic due to her inability to get pregnant for over two years. She is concerned that she is not ovulating even though her menstrual cycle lasts for 35 days and is regular. She is not on any contraceptive and her pregnancy test is negative.

Which of the following is the best way to detect ovulation?

Answer 1

Day 21 progesterone

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Day 21 progesterone test is the most reliable test to confirm ovulation

In simple terms, measure serum progesterone 7 days prior to expected next period (for 28-day cycle: 28 - 7 = 21. For 35-day cycle: 35 - 7= 28).

Question 2

Key counselling points for fertility problems?

Answer 2

Key counselling points

folic acid

aim for BMI 20-25

advise regular sexual intercourse every 2 to 3 days

smoking/drinking advice