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Re: anovulationFrom: DR A N MALPANI (malpani@giasbm01.vsnl.net.in)Sun Mar 22 21:48:25 1998
On Sun, 22 Mar 1998, Robert J. Woolley wrote: > > > > 1) Assume that 4 more months go by like this, without pregnancy, so that > > we're > > talking about real infertility. Assume further that semen analysis is normal. > > > > (Hasn't been done yet.) Would this be enough to diagnose anovulation as the > > cause, or would you proceed with other investigations such as > > hysterosalpingogram? I feel that you should complete the workup of the couple before starting empiric therapy. Suppose you do start the clomiphene and she does not get pregnant in a few months; and you then do a HSG and find that her tubes were also blocked, it would be hard for you to justify having given clomiphene to a woman with blocked tubes ! I think the same rules should apply to the treatment of infertility as to any other medical problem - complete the workup before starting treatment or jumping to conclusions ! However, if the patient agreed to defer a workup and would prefer an empiric trail of therapy first, then this would be an alternative option.
> > 2) When the patient asks "*Why* do I not ovulate?", what would be your
Dr Malpani, MD
> ---------------------------------------------------------------------------
> --------------------------------------------------------------------------- Founder and Medical Director, Health Education Library for People India's First Consumer Health Education Resource Center "Om Chambers",Kemps Corner, Bombay 400 036. India. FAX: 91-22-215 0223. email: malpani@pobox.com Please visit our homepage at http://www.healthlibrary.com !
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